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Dry Eyes After Eyelid Surgery

Posted:11:15 a.m. Monday, July 29, 2013

By Anita Mandal, M.D.
Question: After eyelid lift surgery, my eyes began to water and feel very dry. My plastic surgeon said they would get better, but it has been a year and there has been very little improvement. What can I do?

Answer: It is not uncommon to experience dry eyes within the first few weeks after surgery. Persistent dry eye can occur and, in some cases, can be due to a pre-existing problem or a surgical complication.

Some factors that can make it more likely to develop dry eyes after an upper eyelid lift include thyroid problems, bulging eyelids, prior history of dry eyes, poor eyelid skin tone, weak eyelid ligaments, certain autoimmune diseases, defects in the tear duct pathways as well as removal of too much eyelid skin during surgery or significant postoperative swelling.

When these factors can be identified in advance, measures can be taken to avoid or reduce the risk of permanent dry eye. Depending on the nature of the problem, a conservative eyelid lift with less skin removal may be needed. In other patients, special lid tightening procedures can be done in additional to eyelid surgery to avoid problems. In some cases where there is a high risk of developing dry eyes, complete avoidance of an eyelid lift may be advised.

Treatment of dry eye early on after an eyelid lift often includes the application of saline and/or prescription eye drops as well as lubricating ointments to keep the eyes moist. If dry eye persists for more than a few weeks despite topical treatment, one should see their doctor to identify the cause and treat accordingly.

While permanent dry eye after eyelid surgery can be prevented in many instances, dry eye syndrome is a risk of surgery. Being aware of all the risks of surgery, even when they are low, is an integral part of being a realistic patient. Consideration of surgery mainly when the risks are minimal is the preferred approach.

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