How Long for a Repaired Severed Levator Muscle to Open the Eyelid?

14 month old granddaughter was attacked by dog. Her levator muscle in right eye was severed but repaired. How long before we know if her eye will open?

Doctor Answers (4)

Severed levator muscle

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In adults, it is appropriate to wait several months before worrying about lid position after trauma. In young children, one very important consideration is amblyopia, a condition where the brain favors a better seeing eye. If the damaged eyelid is impairing vision from the eye, go see a pediatric ophthalmologist or an oculoplastic surgeon soon (if you haven't already). Even if the eyelid is not completely blocking vision, the peripheral vision loss and possible astigmatism (gentle warping of the cornea from the weight of the eyelid) can cause the brain to favor the other, "good" eye. 


Irvine Oculoplastic Surgeon

Muscle function after levator repair

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If the levator muscle was repaired after injury, the upper eyelid should exhibit some degree of function. This may be masked by the attendant swelling from the injury, and so it may take a few days for the lid to move normally. You should discuss any concerns with the surgeon who performed the operation.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 5 reviews

She should have some function few days post surgery

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The swelling after surgery will limit the muscle movement,but there should be some degree of the movement. The best person to answer your question is the doctor that did the repair.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 56 reviews

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How Long for a Repaired Severed Levator Muscle to Open the Eyelid?

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Regarding: "How Long for a Repaired Severed Levator Muscle to Open the Eyelid?
14 month old granddaughter was attacked by dog. Her levator muscle in right eye was severed but repaired. How long before we know if her eye will open
?"

The upper lid is lifted just like an old fashion store awning. The levator muscle is short and is attached just behind the upper rim of the eye socket. It fuses into a tough tendinous extentesion called the APONEUROSIS which attaches to the upper edge of a narrow cartilage stiffener , a stave, called the tarsal plate, or tarsus, which runs the width of the lower lid. Along the way, the aponeurosis gives attachments to the skin creating the transverse fold of the eye, the Tarsal Fold, seen in Western eyes.

Any injury to this Levator mechanism (nerve, muscle, aponeurosis, tarsal plate) would result in a droopy eye lid or inability to open the eye. In your case, it sounds like the aponeurosis was cut but repaired. Depending on how extensive the original injury and how the repair was done, you should see upper lid movement when the muscle swelling has subsided. That can take a few days to 2 weeks in some cases. If the muscle itself was damaged, the recovery, if any, would be much slower and more surgery may be needed.

If you are worried, discuss it with the surgeon. I am sure he would be glad to answer you.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.