Is scleral show only treated with lateral canthoplasty/canthopexy?

Question

Apart from lateral canthoplasty/canthopexy, is there any other procedure to treat a scleral show? Although I don't have big problem with my eyes (extreme scleral show), I wish my lower lid could touch the iris and give me a more youthful look. Is it possible to reduce the effect with fat grafting?

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. There are many causes of scleral show and each cause requires a different treatment. Sometimes surgical correction is appropriate, while other times dermal fillers or fat grafts might be helpful. Make an appointment with an eyelid specialist. Good luck.

Brian M. Derby, MD, FACS · Answer

Hi Angel. The cause of scleral show should be determined. Prominent eyes, lid laxity, medial migration of the lateral canthus, anterior lamellar/middle/posterior lamellar shortening, midfacial retrusion are just a few items to consider. While I often combine lateral canthal fixation in cases such as yours, I may need to incorporate a "spacer graft" to support your lower lid, add a mid cheek lift for skin recruitment, and/or add fat or an implant for mid-facial support. So, as you see, the problem can be from an assortment of problems that need to be appropriately identified and addressed. Your consultation would clarify. All my best.

Boris M. Ackerman, MD · Answer

The treatment of scleral show depends on a cause.  In a patient with scleral show after a surgery, a very specific surgical plan is designed depending on the patient's anatomy.  It seems that you have not had any prior surgery, so depending on your age, you could benefit from filler treatment and possibly from sructural fat graft procedure.

Dan Landmann, MD · Answer

Hi Angel, Thanks for your great question. It would be helpful to start with an in person exam or a photo. I would recommend consulting with a doctor that does both eyelid surgery and fillers. Sometimes fillers can be used to structurally lift the lower eyelid. It typically won't do so very much, but it is an alternative option. The other important issue is figuring out why you have inferior scleral show.Good luck!Dan Landmann

Is scleral show only treated with lateral canthoplasty/canthopexy?

Answers (4)

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