Excessive bleeding into the eye after lower eyelid surgery may result in blindness. This is because the bleeding into the eye causes so much pressure that the normal blood flow to the eye cannot get through and blindness may result. Fortunately, this is an extremely rare complication . Well-trained eyelid surgeons know of this complication and meticulously control bleeding during surgery. Postoperatively patients are asked to use ice compresses and not to exert themselves, so as not to cause any unexpected bleeding. During the informed consent process, the physician will mention that blindness is a risk, but luckily, it is very unlikely to occur.
Dear CherriThe risk of blindness associated with blepharoplasty would primarily be from uncontrolled bleeding behind the eyelid after surgery. The expanding pool of blood in the confined space around the eye raises the pressure to the point where the circulation of blood to the retina is effected resulting in loss of vision. This process is called a retrobulbar hemorrhage. It is rare. One doctor here quotes a figure of 1 in 10,000 cases. This figure seems high. That would mean that last year, about 20 people would have gone blind from their blepharoplasty. That many cases would be big news. I have also seen the figure of 1:300,000 and I think that number is too low. So some where in between is probably about right. This makes it a rare event. The problem with rare events is that doctors begin to think it won't happen to them. So if someone tells you they have done X numbers of eyelid surgeries and have never seen it, it really means that have not seen enough cases. How do oculoplastic surgeons manage this risk? First we have our patients avoid medications that thin the blood. This includes medications like Aspirin, Ibuprofen the active ingredient in Advil and Motrin, and almost all herbal products. There are technical steps in surgery that reduce the risk of post-operative hemorrhage. Patients are also instructed to rest in bed after surgery and call immediately for bleeding, pain, or visional reduction after surgery.
