I am a 47 years old woman who had an upper eyelid surgery 2 1/2 years ago. Before surgery my eyes were completely healthy. After surgery and still today Schirmers is 0 mm on both eyes. I cant close my eyes. They cant roll up under the skin anymore, when I try to it hurts, I have to look down under the skin. It hurts all the time. Please, could you tell from my pictures what went wrong and are there anything to do about it ? Pictures taken one week before surgery and 2 1/2 years after surgery.
Dry eye syndrome after upper eye-lid blepharoplasty Is there anything to do to make my tear function work again? (photo)
Doctor Answers 2
Upper blepharoplasty can and does damage the motor nerves that help close the eyes.
In your photos, it is very clear that the eyelid platform orbicularis oculi muscle is very atrophic. This contributes to dry eye. There are a number of non-surgical options to improve dry eye symptoms. Seeing an oculoplastic surgeon is a reasonable suggestion. However, a cornea specialist is also an appropriate choice and they will be less likely to pressure you to have more surgery.
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Unable to close eyes after blepharoplasty
You post good, descriptive photos. Your eyes obviously don't blink or close well, causing your eyes to be exposed to air, resulting in dry eyes. The problem may be from tight eyelid, lack of skin, and/or weakened orbicularis oculi muscle (which is responsible to close the eyes). The bad news is that dry eyes get worse with time as everyone make less tear as they age. The good news is that depending on the problem, a different treatment is possible, to help close (protect) the eyes. See an oculoplastic surgeon for evaluation and treatment.