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Ask Dr. Gott 4/30
Eye-socket cholesterol leaves woman looking for answers
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    DEAR DR. GOTT: I have cholesterol deposits in my eye sockets. They first appeared when I was in my early 30s, at a time when I was very athletic. My cholesterol level was so low that I tested out in the rare category. I went to an allegedly reputable eye surgeon, who told me I had cysts. He removed them surgically, leaving me with no eyelashes on the outside corners of both eyes, one eye a different shape than the other and scarring in the lower lash line. The deposits ultimately returned, and now there is a considerable amount below both eyes. I also have very small deposits above my eyes.
    I've tried to research this process to understand what is happening in my body that creates this condition. I think it is a result of high lipidity in the bloodstream, but I don't understand why this happens and what to do about it. I have lowered my fat and alcohol intake. I take a thyroid supplement, but nothing seems to have stopped this process. I exercise moderately, don't consume a lot of sugar or carbohydrates and follow a fairly healthful eating program.
    Is there a nutritional and supplemental program or published literature that you can recommend that will help halt this process? My cholesterol is in the average range. I'm a 58-year-old postmenopausal white female with no other health problems. I'm considering laser therapy to remove the deposits again and would like any information that can contribute to addressing this condition.
    DEAR READER: I believe you have a form of xanthoma (fatty deposits under the skin) called xanthelasma palpebra (xanthoma of the eyelids).
    This condition often occurs in older people and those with high cholesterol or triglyceride levels. You say that your cholesterol is in the average range, so I don't believe this is causing your problem. Have you also had your triglyceride level checked? Perhaps this is the root of the problem. Other possible causes include diabetes, certain cancers and primary biliary cirrhosis (inflammation of the bile ducts in the liver, which causes narrowing, obstruction and damage to liver cells). Most people do not have a specific cause. However, because xanthomas can be caused by very serious conditions, I urge you to be examined and tested by your primary-care physician. Because of your very healthful lifestyle and good health, I believe you will fall into the category of "no known cause."
    Treatment can be difficult. Depending on the cause (or lack of one), there are some options. For those with high cholesterol or triglycerides, the deposits often disappear within a few months of treatment with cholesterol-lowering medication. Diabetes treatment will reduce them once the blood sugar is brought down and kept under control. For those who do not respond to treatment of the underlying disorder or do not have a diagnostic reason, the deposits can be removed with surgery or laser treatments. They often return despite removal.
    To give you related information, I am sending you copies of my Health Reports "An Informed Approach to Surgery" and "Understanding Cholesterol."
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