Asian eyelid surgery side effects: Are the tear ducts touched at all during that procedure?

Question

I had blepharoplasty and epicanthoplasty done over 4 months ago. I've noticed that for the past 2.5 months, sometimes(1-2times a day) my left eye would tear up constantly for 30 minutes up to an hour while my right eye will be extremely dry during that same time to the point where eye drops, eye gels, eye lubricant won't help. I really don't think it's due to any environmental allergies. Is this a side effect from my eyelid surgery?

David Cheung, MBChB, Bsc(Hons), FRCOphth · Answer

Hi. Greetings from the UK! What you're describing sounds very much like what we call in the business as reflex hyperlacrimation. Although epicanthoplasty surgery done badly can damage the tear duct drainage apparatus, it's pretty unlikely. Indeed even if you do have punctal or upper canalicular damage due to bad epicanthoplasty surgery, many patients would not notice that much watering afterwards as they'd still have a patent lower canalicular system which does more of the work. You're probably complaining of tearing often accompanied with irritation and redness worsened in the cold wind and whilst reading or concentrating- i.e. watering in response to ocular surface irritation. It would be worth seeing an oculoplastic surgeon so that they can assess your ocular surface and look for any post operative non-closure of your eye (lagophthalmos). You may also have something completely unrelated such as meibomian gland dysfunction. Paradoxically you would therefore likely benefit from better lubricants such as they hyalauronate based lubricants or punctal plugs which conserve your tear film, keeping your eye more comfortable hence suppressing your reflex watering. Hope that makes sense.

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David
Mr David CheungBsc(Hons), MB ChB, FRCOphth, FRCSEdConsultant Ophthalmic and Oculoplastic Surgeon with a Special Interest in Lid, Lacrimal and Orbital Surgery

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David
Mr David CheungBsc(Hons), MB ChB, FRCOphth, FRCSEdConsultant Ophthalmic and Oculoplastic Surgeon with a Special Interest in Lid, Lacrimal and Orbital Surgery

Chase Lay, MD · Answer

Hopefully you're still healing and some swelling is creating an issue with tear duct drainage; if that's the case this should resolve.  However, you need to go see and ophthalmologist (and your surgeon) and have the punctum and ducts examined for proper drainage with eye drops with dye in them or probing or both.Chase Lay MDAsian eyelid surgery specialist.

Darab Hormozi, MD · Answer

I wishe you had included a photo to make assessment easier.  Without a photo, I would guess that your left eye has problem closing sometime at night only and sometimes all the time.  That usually create exposure and irritation that manifest with tearing and discomfort.  I suggest to see your surgeon to address the issue although you still have some healing to do and small exposures can resolve spontaneously with scar resolution.

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