Dr. Shalu Pal

  • "If you want quality and wonderful service, please go to Dr. Shalu Pal! The patience, care, and true concern that Dr. Pal has for her clients is wonderful. "

    --Seleena J
  • " I was pleasantly surprised by finding a hidden gem within Dr. Pal's office"

  • "Finally a doctor who is extremely knowledgeable, patient and explains things clearly. She is a wonderful human being who really takes the time to care for your needs. The office has a wonderful atmosphere and the staff are just as helpful as Dr. Pal. "

  • "I couldn't ask for a better Optometrist. She is a delight to deal with, very patient, helpful and extremely knowledgeable. She was very good with my kids who can be very fussy at times.. And who could ask for a more beautiful location. Highly Recommend! "

    --Natalie M.
  • "My wife and I, highly recommend Dr. Pal. The staff, the service, the merchandise, are all top notch. They really make you feel welcomed. It has been several years since I have been able to see this well !!! You and your staff are the best !!!! "

    --Steve and Maria L.
  • "We barely go to optometrists so when we do, we should look for the best! I am super pleased I chose Dr. Pal\'s office. They were helpful from beginning to end, from booking on the phone to my actual visit. Dr. Pal was very detailed and went in-depth about my eye health. She is very patient and made me feel calm. The optician helped me pick a great pair of glasses, they were genuinely friendly which is a huge bonus."

    --Ahmad S
  • "I have been going to Dr. Pal for several years now. My most recent visit on June 6, 2016 was the best experience there that I have ever had. Firstly, the women on the desk were friendly and efficient - a very good prelude to my examination. Dr. Pal, herself, was, as usual, very thorough and encouraging in her examination. And she puts you at ease before we get into the eyes examination by discussing other things in life. That helps to ease any stress I may have. And they now have a man in the office who does that difficult examination (name of which I do not know!). He is so patient and encouraging and made the exam not so difficult for me this time. After all that, I saw Dr. Pal again before I left and she told me my eyes were good! Even had the news been not so good, I believe that I would be able to handle it because I truly believe that Dr. Pal and her staff would have taken good care of me. I will always go back to Dr. Pal and members of her team because I truly believe"

    --A. Howlett
  • " I have been to a few appointments at Dr. Pal\'s office over the last year for dry eye issues and every time it has been a very positive experience. The 3 receptionists at the front desk are warm and friendly. They are attentive and provide a very high level of customer service. I appreciate that they call me by name and remembered conversations we had at previous visits. I find Dr. Pal to be an excellent practitioner who is very thorough with her exams, has a lovely personality and takes the time to answer any and all questions that may arise. I am happy with the computer glasses I purchased and value the honest opinions I received from the staff when selecting frames. It was refreshing to have multiple opinions on styles and I felt they truly wanted me to walk out with a frame that was best suited to me. I highly recommend Dr. Pal \'s office! As a health care practitioner myself, I think all health care experiences should be this personilzed and friendly!"

    --A. Mclean



As we age, most of us experience the facial wrinkles and sagging skin associated with having celebrated more birthdays. Unfortunately, sometimes that relaxation of the tissues of the eyelids causes a condition called ectropion that results in the bottom lid sagging downwards and outwards so its edge is no longer right next to the globe.

Our tears are constantly being replenished by glands in both lids and the lacrimal gland, located above each eye. The excess tears normally escape the eye through two tiny ducts that drain into the nasal cavity. Each eyelid, the upper and the lower, has its own duct. The tears drain into them by capillary action, but in order for this to work properly, both lids must be in contact with the globe. The lower lid in particular is important because most of the drainage work is handled there; even if the upper lid is in its proper position next to the globe, gravity causes most of the fluid to drain into the lower duct opening.

Entropion, a different disorder where the lower eyelid rolls inward, has similar causes. The two types of improper lid alignment are sometimes confused, but are quite different.

Because the eyelid is no longer up next to the globe, the lower areas of the eye can become dried out and damaged because they are exposed to the air. . (See photo at right; edge of lower lid is sagging away from the globe, allowing the tears to form a pool. Normal tear drainage is also ineffective, because the duct opening is also sagging away from the globe.)

Ectropion is usually seen in older adults, although sometimes it is seen in infants if there is insufficient skin in the lids at birth. In other cases, trauma to the eye after burns or surgery on the lids can cause scarring in what is known as cicatricial ectropion. There is also an increased incidence of ectropion in people who suffer from chronic ocular allergies, thought to be caused by the constant rubbing of the eyelid tissues, stretching them so they sag outwards.


The tears are made mostly of saline; if there is impaired drainage, the fluids pool into the pouch formed by the sagging lid and will eventually overflow, causing skin irritation. The overflow irritates the skin below the eyes; this is usually perceived by the person experiencing it as excess eye watering. Rubbing the eye only makes the lid sag more and makes the problem worse.

Ectropion usually includes some or all of these signs and symptoms:

  • Sagging eyelid skin around the eyes, particularly noticeable in the lower lid
  • Redness
  • Burning
  • Itching
  • Dryness of the eye
  • Eye irritation
  • Excess tearing
  • Thinning eyelid tissues
  • Inflammation of the lining of the eye, called conjunctivitis

It seems like a contradictory finding, but the pooling of the tears in the lower lid can cause other areas to be dry and irritated, which causes more tearing in turn, and the cycle continues.

These signs do not always indicate ectropion, but if you experience one or more of them, see your eyecare practitioner.

Left untreated, the salinity of the overflow will cause skin irritation and even erosion; also, because the lids aren’t draining properly, the lower part of the eye can become chronically dry, causing damage to the ocular tissues, especially the lower cornea and conjunctivia.


In mild forms, ectropion can be treated with artificial tears which will reduce the irritation and calm the production of excess tears in response to the dryness.

In addition, patients should try to decrease the rubbing of the lids and instead use a blotting action to soak up the fluid. Try to avoid rubbing the lower lid, especially towards the temples as this will only cause more stretching and will not improve comfort.

In most cases, surgical intervention is usually required to tighten the tendons in the eyelids and bring them back into contact with the eye.

Surgery for ectropion is usually uncomplicated and will result in a noticeable improvement in comfort and appearance; the surgery acts to restore the normal position of the lid next to the eye. The lids themselves take over once they are back in position.

If you experience burning, tears overflowing your lower lids or any other symptoms, see your eyecare practitioner for advice as ectropion does not reverse itself or get better with time.

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