Residual fluid in eye post-bleph (Photo)

Question

I am 6 months post-op upper and lower bleph with fat transfer, and I have this lingering fluid left on the lower lateral part of my left eye. My plastic surgeon had prescribed tobramycin/dexamethasone drops to try a few months back, but it didn’t help. I did recently see an ophthalmologist and they removed a stye on my lower lid, but the fluid has not resolved. She recommended to try the drops again for a week but so far no change. Any other suggestions? The fluid fluctuates at times.

Kenneth D. Steinsapir, MD · Answer

Stop using the Tobramycin/dexamethasone drop. It is actually highly irritating and likely only going to make your chemosis worse. Your chemosis is likely due to chronic corneal exposure and drying. The corneal exposure is likely a direct consequence of your eyelid surgery. You have post blepharoplasty lower eyelid retraction. The upper eyelid is also a mid over done in my opinion. Your upper eyelid is riding a bit high on the cornea. The net result is that too much exposure of the eye surface causing chronic eye surface exposure. This accounts for the chemosis. The aggressive use of bland ( not medicated) eye drops that are preservative free will help. A preservative free ointment at bedtime are also useful. Ultimately you would benefit from eyelid reconstruction. You will need to see an aesthetic eyelid reconstruction specialist.

Thomas Spalla, MD · Answer

This issue is not uncommonly encountered after blepharoplasty. It is more commonly seen in lower blepharoplasty, but it can occur after an upper blepharoplasty as well.

Conservative treatments for chemosis include: ocular surface lubrication, pressure patching, steroid eye drops, warm compresses, and gentle massage. If conservative treatments don't work, other options include: Hand-held fine-tip cauterization or conjunctival opening to release fluid from the chemotic blister.

Mats Hagstrom, MD (license on probation) · Answer

From what you have presented, I believe your situation is sufficiently complex that you should probably rely exclusively on in person consultations.
While it is time-consuming and there may be potential cost involved getting in person second opinion, consultations from oculoplastic surgeons in your community is probably the right course of action.
 If I understand your concern correctly, there is an insufficient drainage of tears in your eye that accumulate in the lateral canthal area. If not than what is the fluid. 
I have read the responses from the other providers and while well written they sound a bit like a presidential candidate answering a controversial question. I suppose mine did as well. 
I’m not an Oculoplastic surgeon, but I think I have enough insight to recognize the limitations of virtual medical care.
To recommend a successful treatment, we need to first have a clear understanding of the problem.
Best,
Mats Hagstrom MD

Residual fluid in eye post-bleph (Photo)

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Residual fluid in eye post-bleph (Photo)

Answers (3)

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Our mission is to create a world where every investment in modern beauty is Worth It.