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Excessive Width of Medial Canthus - Lagophthalmos - Ptosis - Dry Eyes

asked 11 months ago by Tankie in Victoria, BC
Latest answer by Guy Massry, MD
Question viewed 240 times
Tags: ptosis, dry eyes, lagophthalmos, wide

- Experiencing dry eyes from excessive width of medial canthus (both eyes). - Problem from ages 20-24; I do not know what caused it. - My oculoplastic surgeon performed lower eyelid lengthening with sclera graft (both eyes). - I believe lagophthalmos is a result of excessive canthus width. - I do not know what caused ptosis. - Unable to fully close eyes. - I have never been able to wink with my right eye my entire life. What options are available to help me?

4 answers to Excessive Width of Medial Canthus - Lagophthalmos - Ptosis - Dry Eyes

+3

There is no substitute with a personal consultation with a true expert.

Your history with regard to your issues and the time of the surgery is not clear. Aggressive lateral canthoplasty can pull the medial canthal tendon as you illustrate in your photos. Unintended side effects of a large canthotomy, a step in the lateral canthal tightening procedure can actually weaken or paralyze the orbicularis oculi muscle of the upper eyelid platform worsening eyelid closure and lagophthalmos. There is room for debate but some patients experience... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+2

Dry eye and ptosis

Hello I would strongly recommend another opinion from an ophthalmic plastic surgeon. It is hard to tell from the history given and photos what the cause of your issues are. A detailed examination would shed light on this. Be patient and attain data to make the best informed decision. Avoid surgical intervention until you have all the information you need.
Guy Massry, MD

Los Angeles Oculoplastic Surgeon
+2

Eyelid problems

Eyelids are very complex structures, and correction of small problems (what you refer to as canthal width) may not be possible. This is certainly a case for an oculoplastic surgeon. Be prepared to accept his advice if he suggests that surgery is inappropriate at this stage.
Hugh McLean, MD

Mississauga Plastic Surgeon
+2

RE: eyelid issue

You need to first find out why you have the symptoms, before trying surgrery. It is difficult to understand from your history and photos what the problem is. Consider consult with oculoplastic surgeons. Dr Taban
Mehryar (Ray) Taban, MD, FACS

Los Angeles Oculoplastic Surgeon

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