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Eyelid and tear duct surgery

Medically known as oculoplastic and lacrimal surgery, this describes a variety of procedures that focus on disorders of the eyelids and tear ducts. These types of eye conditions can affect your vision, eye comfort and eye health as well as your appearance – so often, surgery is an option to relieve bothersome symptoms.

Which conditions can be treated?

Some of the most common reasons for referral to an oculoplastic and lacrimal surgeon is for treatment for the following conditions

Dry eye

Tears play an important role in keeping the eye’s surface healthy. If our eyes do not produce enough tears, or if they are poor quality, it can lead to dryness which can leave the eyes feeling gritty, sore and tired.

Eyelid lumps and bumps

The majority of lumps and bumps on the eyelids are harmless and resolve spontaneously, but sometimes they can require removal. Very occasionally, these changes around the eyelids may not be benign. Suspicious signs include continued growth, a non-healing ulcer with occasional bleeding, and a loss of eyelashes if near the eyelid margin.

Misdirected eyelashes (trichiasis)

Instead of facing outwards, sometimes the eyelashes can grow inwards, towards the eye. This can happen if the lower eyelid turns in from ageing (entropion), abnormal growth on the edge of the eyelid, and in rare cases, it can be genetic. Trichiasis can make your eyes feel quite uncomfortable and can increase the risk of eye infections, so it is sometimes necessary to remove any misdirected eyelashes.

Drooping eyelid (ptosis)

Ptosis can be present at birth but often occurs later in life as the eyelid muscles deteriorate with age. It can also be associated with long-term contact lens wear or trauma after eye surgery. Less commonly, it’s caused by problems with the lid muscles themselves or their nerve supply. Ptosis causes problems with sight if the eyelid covers part of the pupil.

Outward turning eyelid (ectropion)

This happens when one or both lower eyelids turn outward and away from the eye. Ectropion disrupts the drainage of tears, which can cause the affected eye to become sore, red or watery and more vulnerable to infections, such as conjunctivitis. Most cases are age-related, but it can be caused with problems with the nerves in the eyelid, or damage to the skin around the eyelid.

How is the surgery done?

Each surgery is different and tailored to the requirements of each patient. Your consultant will discuss what kinds of treatment or procedures you’ll need and will be able to take you through everything you need to know before your surgery takes place.

Typically, you might expect these kinds of treatments:

  • Eye drops to lubricate the eye
  • Procedure to repair or reform the eyelid
  • Procedure to insert tiny plugs into the tear duct to encourage proper drainage
  • Simple outpatient procedure to remove lumps and bumps on the eyelid

How do I get referred?

Your optician or GP will discuss the various treatment options available to you and where you can choose to have your treatment. You’ll be able to take the time to decide where you’d like to be treated, and your GP or optician will make the arrangements for your referral.

How to refer?

Please follow your local protocol regarding referrals – we accept direct referrals by secure email, fax, OptoManager and post. Please call us on the number at the top of this page if you would like any further information about making a referral to Newmedica.

Going private

It is not always possible to receive NHS funding for eyelid and tear duct surgery. Your GP will be able to check your eligibility for your case and area. Otherwise, Newmedica is able to offer consultant-led private oculoplastic surgery at an affordable price.

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  • BMI >40, weight >160kg and unable to transfer independently
  • Uncontrolled hypertension – persistent diastolic >100mmHg
  • MI or CVA within 3 months of surgery MRSA positive
  • Active exposed skin infection Indwelling defibrillators
  • Poorly controlled diabetes – BS >20

For optometrists
Send a letter to the patient’s GP with GOS18 requesting an onward referral via ERS.

For GPs and Referral Centres
Send a referral form to Newmedica with GOS18 by post or secure fax 020 7924 6262 or email to: 
newmedica.referrals@nhs.net

Cataract and oculoplastic referrals will be assessed against local criteria.

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