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Nearly Closed Eyelid After Botox Injections

I have a history of unilateral Thyroid Eye Disease (TED) in the right eye. I had Botox about 17 days ago, and now, the left lid is almost closed. This exacerbates the appearance of the TED lid hyper-retraction. What can I do?

Doctor Answers (4)

Thyroid eye disease and botox


What you have is a common phenomenon. You have ptosis or a droopy eyelid from the botox. As a result you are cranking up both eyelids to see better out of the droopy eyelid. As a result the already high eyelid is elevating higher. This is known as a herring's phenomenon. This will get better once the botox wears off. 

Washington DC Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Compensatory right upper eyelid retraction


Dear Lid Dispair

You are obviously having a serious problem after a BOTOX treatment. It does sound like the treatment has caused ptosis of the left upper eyelid. This causes a compensatory effort to lift the eyelids. The left one under acts but this effort cause retraction in the right upper eyelid.

I would strongly recommend that you be seen by an eye plastic surgeon. The oculoplastic surgeon who manages your thyroid eye disease is an excellent choice. They will be able to assess you and make sure the the retraction on the right side is not causing the cornea to dry out.

Iopidine drops may help. These drops do not always work initially. They are only effective if there is some muscle activity. If the drops work initial, is suggests the ptosis will last 4 to 6 weeks. If the drops initially don't work, then the ptosis may last 3-4 months and possibly longer.

If you don't have an eye plastic surgeon, look at the ASOPRS website. This has a zip code directory for eye plastic surgeons in the US and Canada.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 18 reviews

Iopidine drops may help



It sounds like you have eyelid ptosis on the left side. If untreated, the effects revers after 4 to 5 weeks. Your doctor may want to consider Iopidine drops as long as there is no contraindication with your thyroid problems. Iopidine may not help much, but rest assured that the problem is self-limited and will disappear with time.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 15 reviews

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