Why do we patch cross-eyed kids?
It is sometimes necessary to patch an eye in children with an eye turn. The part of the brain that assembles the information from the eyes into a picture is not fully mature until about 7 years of age. When a child less than this age prefers to use one eye over the other due to a turned eye or other abnormality, the cells in the brain representing the underutilized eye do not fully develop. Without patching to force the use of the neglected eye before the crucial age, these cells never will fully develop. Amblyopia, a permanent decrease in vision, is then seen for that eye. This is not correctable by any means after cortical maturation is complete.
Before any surgery to re-align crossed or turned-out eyes, it is best to patch the eyes to obtain best possible vision. This helps the child keep a clear picture in both eyes and causes the eyes to maintain better alignment during the healing phase after this type of surgery.
What can I do about baggy eyelids?
Baggy upper and lower lids often are caused by heredity and age. People with atopy or allergies who frequently rub their eyes vigorously may accelerate this process by gradually stretching the skin. In addition, there are specific genetic syndromes that can cause this problem. Allergic “shiners” seen over the lower rim of the bone of the eye socket may be a clue to the cause. Aging and thinning skin and loosening eyelid support structures may also allow orbital fat pads to protrude into the lids instead of remaining in their intended position behind the rim of the eye socket. This causes a lumpy appearance.
Upper and lower lid re-contourings are called blepharoplasties. These have several variations in technique depending on the individual patient’s situation. We do these procedures locally, both for cosmetic reasons, and for also people in whom the drooping skin obstructs their visual field or interferes with their eyelashes or lid function. Eyelid tightening and brow or forehead lifting surgeries may also be required to obtain a good result, as these structures all impact each other if not functioning properly.