This page collects the questions patients ask me most often during consultations. The answers are general information and none of them replaces an examination. The same complaint can have different causes in different people, and a treatment decision can only be made after an eye examination.
Most of them concern eyelid disease and eyelid surgery, the tear drainage system, the ocular surface and children's eye health. The detailed account of each subject is on its own page: eyelid diseases, cosmetic eyelid procedures, lacrimal system disorders, ocular surface diseases, cataract, prosthetic eye and pediatric eye diseases. The full list is on the treatments page.
If your question is not on the list, you are welcome to ask it during the consultation. When surgery is being considered, I explain the technique, the alternatives, the recovery process and the possible risks before the procedure. How I work is described on the about me page, and my training history on my resume page.
As an Ophthalmologist, Dr. Ayşe Dolar Bilge, I provide diagnosis and treatment services with my experienced team.
The most common cause of a drooping eyelid is stretching of the tendon of the levator muscle over the years. There are also congenital forms and forms related to nerve disease or trauma. Excess skin hanging over the upper lid is called pseudoptosis and has to be distinguished from true ptosis, because the surgery is different.
True ptosis has no form that resolves without surgery; the treatment is surgical. I decide what to do after measuring how far the lid has dropped and how well the levator muscle works. The ptosis page explains this in detail.
Blepharoplasty is the medical name for eyelid surgery. In the upper lid, excess skin and where necessary fat tissue are addressed; in the lower lid, under-eye bagging is corrected. The upper lid incision is placed within the natural lid crease, so the scar becomes indistinct over time.
Swelling and bruising are most obvious in the first days and usually settle considerably within the first week. Depending on the person, the social appearance takes a few weeks to settle and the tissues a few months to take their final position. The process does not move at the same pace in everyone. See the cosmetic eyelid procedures page.
It is a surgery that we recommend especially for young patients. If the only problem of the patient is bags under the eyes and there are no accompanying problems such as sagging skin or eyelid laxity, the surgery is performed with a hidden incision made behind the eyelid, and no skin scars are left.
It is a method we apply in cases of under eye bruising and hollowness called tear trough deformity in the lower eyelid. Contrary to popular belief, not every under eye bruising patient may be suitable for this treatment. In fact, it is similar to the fillers used in other areas of the face. However, the sensitive anatomical features of the eye area require the use of special products and techniques. It works wonders in suitable patients.
A stye develops when the oil glands at the lid margin become blocked and inflamed, producing redness, tenderness and a localised swelling. Many styes settle within a few days with regular warm compresses and lid margin cleaning.
An examination is needed if the swelling grows, the pain increases, vision is affected or the problem keeps returning. Recurrent styes often sit on top of blepharitis, inflammation of the lid margin, and that is what actually needs treating. Do not squeeze the lid or try to burst it.
Eyelashes turning inwards and rubbing the cornea is called trichiasis. The main causes are chronic inflammation of the lid margin, scarring from previous injury or surgery, structural change in the lid margin, and inward turning of the lid (entropion). It causes a constant foreign-body sensation, watering and redness, and if left untreated it can damage the corneal surface.
Pulling the lash gives temporary relief; it grows back within a few weeks. A lasting solution means destroying the lash root when only a few lashes are involved, or surgical correction of the lid margin when the problem is widespread. If entropion underlies it, the position of the lid is what has to be corrected. See the ingrown eyelashes page.
Entropion is the inward turning of the eyelid margin towards the eye. The most common form follows the loosening of the lid tissues and muscles with age; it can also arise from chronic inflammation and scarring of the ocular surface, from previous injury, or from congenital causes.
When the lid turns in, the lashes rub against the cornea, causing irritation, watering, redness and light sensitivity. Lubricating drops and taping ease the symptoms temporarily, but the lasting solution is surgery that restores the position of the lid. The details are on the entropion page.
Watering has two main causes: too many tears being produced, or the tears that are produced not draining properly into the nose. The first group includes dry eye, blepharitis, allergy and irritation of the ocular surface; dry eye causing reflex watering is common and often surprises patients. The second group includes narrowing of the tear punctum, duct obstruction and malposition of the lids.
The two are distinguished during examination, by assessing the patency of the tear drainage pathway and the position of the lids. Treatment depends entirely on the cause, so the first step with a watering eye is establishing what that cause is. See the lacrimal system disorders page.
In adults, the surgical treatment for tear duct obstruction is dacryocystorhinostomy (DCR). The operation creates a new passage between the tear sac and the nasal cavity, bypassing the blocked duct. It can be performed endoscopically through the nose or through a small incision at the inner corner of the eye; which route suits depends on the site of the obstruction and on whether there has been previous surgery.
Like any operation it carries risks: bleeding, infection, closure of the new passage over time, and a scar with the external approach. We discuss the risks and the expectations in detail before surgery. For revision of duct surgery that has not worked, see this page.
No. A prosthetic eye does not restore sight; it is a custom-made prosthesis that fills the place of an eye which has lost its vision or has been removed, both structurally and in appearance. It preserves the symmetry of the eye region, keeps the eyelids in the correct position and helps the socket hold its shape.
Because the prosthesis sits on the structure connected to the muscles behind it, it moves to a certain degree with the seeing eye, which gives a natural appearance. It needs regular cleaning and periodic review. The details are on the prosthetic eye page.
Astigmatism means the refracting surfaces of the cornea or the lens are not equally curved in every direction, and it is largely a matter of the eye's own structure. Its degree can shift somewhat during childhood, but it is not reasonable to expect it to disappear entirely on its own.
What matters is recognising astigmatism early and correcting it with glasses when needed; uncorrected astigmatism can affect the development of the visual system and lead to amblyopia. Because that development continues only up to a certain age, an early examination is decisive. See the astigmatism in children page.
This widespread belief about this surgery is not true. With current surgical methods, the risk of recurrence is close to zero with the surgical method we apply, which uses a thin membrane-shaped patch (autograft) taken from the surface of the person's own eye.
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