Minor Procedures

Kingston Eye Institutes state of the art Ambulatory Surgery Center is also available for minor eye lid procedures. The following is a list of procedures performed by Dr. Smallman.

Entropion – is a medical condition where the eyelid is turned inward or rolled towards the eye. An eyelid that is turned in rubs against the eye making it irritated, painful and sensitive to light and wind. If not treated the condition and lead to excessive tearing, mucous discharge, scratching and/or scarring of the cornea.

Overtime, a turned in eye can result in acute sensitivity to light and may lead to eye infections, corneal abrasions or corneal ulcers. It's important to have an entropion repaired before it does permanent damage.

There are a couple of options for entropion repairs. The most common surgical repair involves tightening of the eyelid and its attachments to restore the lid to its normal position. This is an outpatient procedure and patients generally recover quickly using an antibiotic ointment.

Ectropion – is a medical condition where the lower lid turns outward or is sagging away from the eye. The sagging lower lid leaves the eye exposed and dry. Normally the upper and lower eyelids close tightly protecting the eye from damage and preventing tear evaporation. If the edge of one eyelid turns outward the two eyelids can't meet properly and tears are not spread evenly over the eye.

If ectropion is not treated the condition can lead to chronic tearing, eye irritation, redness, pain, a gritty feeling, crusting of the eyelid, mucus discharge and breakdown of the cornea due to exposure.

The condition is generally the result of tissue relaxation associated with normal aging. It can also occur as a result of certain neurologic conditions like Bells Palsy or stroke where there is facial nerve paralysis. Other causes include trauma, scarring, previous surgeries or skin cancer.

Ectropion can be repaired surgically and several patients experience resolution of the problem immediately. Little, if any post operative discomfort has been reported and once the eyelid heals your eyes will feel comfortable and be protected from corneal scarring, infection and loss of vision.

 Nasolacrimal Duct Irrigation & Probing – Probing of the nasolacrimal duct is done to open the valve between the nasolacrimal duct and the nose. When you have a blocked tear duct, your tears can't drain normally, leaving you with a watery, irritated eye. Blocked tear ducts are caused by a partial or complete obstruction in the tear drainage system. A blocked tear duct almost always is correctable. Treatment depends on the cause of the blockage and your age. Possible symptoms include; Excessive tearing, recurrent eye inflammation (conjunctivitis), recurrent eye infections, painful swelling near the inside corner of the eye, mucus or pus discharge from the lids and surface of the eye and blurred vision

The lacrimal glands produce most of your tears. These glands are located inside the upper lids above each eye. Normally, tears flow from the lacrimal glands over the surface of your eye. Tears drain into tiny holes (puncta) located in the corners of your upper and lower eyelids.

Your eyelids have small canals (canaliculi) that move tears to a sac where the lids are attached to the side of the nose (lacrimal sac). From there, tears travel down a duct (the nasolacrimal duct) draining into your nose. Once in the nose, tears are reabsorbed.

A blockage can occur at any point in the tear drainage system, from the puncta to your nose. When that happens, your tears don't drain properly, giving you watery eyes and increasing your risk of eye infections and inflammation.

Blocked tear ducts can happen at any age and causes can include;

Age-related changes - As you age, the punctal openings may get narrower, causing partial blockage that slows the flow of tears into the nose, resulting in tearing. Total blockage of the punctal openings also may occur.

Eye infections or inflammation - Chronic infections and inflammation of your eyes, tear drainage system or nose can cause your tear ducts to become blocked.

Facial injuries or trauma - An injury to your face can cause bone damage near the drainage system, disrupting the normal flow of tears through the ducts.

Tumors - Nasal, sinus or lacrimal sac tumors can occur along the tear drainage system, blocking it as they grow larger.

Topical medications - Rarely, long-term use of certain topical medications, such as some of those that treat glaucoma, can cause a blocked tear duct.

Because your tears aren't draining the way they should, the tears that remain in the drainage system become stagnant, promoting growth of bacteria, viruses and fungi. These organisms can lead to recurrent eye infections and inflammation. Any part of the tear drainage system, including the clear membrane over your eye surface (conjunctiva), can become infected or inflamed because of a blocked tear duct.

Occasionally, the probing and irrigation procedure will not completely open a valve, or may not keep it open permanently. If that happens, another procedure may be needed to open the nasolacrimal duct.

Removal of Lesions, Lumps and Bumps -As we age, it's not uncommon to see an increase in benign eye lid lesions, lumps and bumps on our skin. An effective method of removing these lesions is through surgical excision. Surgical excision is an effective solution to many small benign lumps and fatty deposits and often has a much higher success rate in treating chronic lesions versus alternative topical approaches.

One of the more common procedures patients come to see Dr. Smallman for is a chalazion removal. A chalazion is a chronic stye on their upper or lower eyelid. If one of the eyelids' oil-secreting glands is blocked, a pea-sized enlargement on the eyelid can result. Dr. Smallman can surgically remove these lesions by making a small incision on the eyelid to remove the lump and clear the blockage. The removal process of this type of lesion is usually quick, often taking less than 5 minutes with a local anesthetic. Depending on the severity of the lesion, your recovery time should be fairly quick and relatively painless. You may be required to wear an eye patch for a few hours after the procedure; sutures are not normally required and pain is minimal to nonexistent.

Ask your Doctor to refer you to Kingston Eye Institute to see if any of these procedures are right for you.