I had Blepharoplasty 3 weeks ago, and I wrote here you about droopy eyes. I went to see my surgeon and he diagnosed chemosis, but an oculoplastic from the University of Miami told me she could not see it. They both ordered massage and eye drops. My surgeon also prescribed Tobradex, but the oculoplastic surgeon said that steroids don't help and can cause glaucoma. I am confused. Could you diagnose what I have? Is it ectropion or chemosis? And above all, can it be fixed?
Answer: Bascom Palmer has great eye plastic surgeons Dear Scared You can be completely confident with the oculoplastic surgeons at the University of Miami. They are extremely experienced in dealing with these issues. Unless your original surgeon was an ophthalmologist or a fellowship trained eye plastic surgeon, you were not examined using a slit lamp microscope which is a very specialized piece of equipment that general plastic and facial plastic surgeons are not trained to used and don't possess in their offices. This instrument is very helpful to identify even trace amounts of chemosis, which is swelling of the conjunctiva, the white of the eye. In fairness to your original surgeon, you may have initially had chemosis but as the swelling resolves, the chemosis can also settle. Regarding tobradex, the steroid in this medication can raise the eye pressure. The antibiotic is also irritating. There are specific indication for this medication but treating chemosis is not one of them. On balance, a bland ophthalmic ointment without the steroid or the antibiotic would serve the same purpose. This may be helpful at bed time to keep the eyes from drying out. An artificial tear drop every few hours during the day will also keep the eye more comfortable. So the doctor you saw at the University of Miami is correct in their assessment and management. This should not be surprising as a full time university base eye plastic surgeon will have much more experience in eyelid surgery than your community based plastic surgeon. And yes this can be fixed. Take a look at my website: lidlift.com for examples of these repairs.
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CONTACT NOW Answer: Bascom Palmer has great eye plastic surgeons Dear Scared You can be completely confident with the oculoplastic surgeons at the University of Miami. They are extremely experienced in dealing with these issues. Unless your original surgeon was an ophthalmologist or a fellowship trained eye plastic surgeon, you were not examined using a slit lamp microscope which is a very specialized piece of equipment that general plastic and facial plastic surgeons are not trained to used and don't possess in their offices. This instrument is very helpful to identify even trace amounts of chemosis, which is swelling of the conjunctiva, the white of the eye. In fairness to your original surgeon, you may have initially had chemosis but as the swelling resolves, the chemosis can also settle. Regarding tobradex, the steroid in this medication can raise the eye pressure. The antibiotic is also irritating. There are specific indication for this medication but treating chemosis is not one of them. On balance, a bland ophthalmic ointment without the steroid or the antibiotic would serve the same purpose. This may be helpful at bed time to keep the eyes from drying out. An artificial tear drop every few hours during the day will also keep the eye more comfortable. So the doctor you saw at the University of Miami is correct in their assessment and management. This should not be surprising as a full time university base eye plastic surgeon will have much more experience in eyelid surgery than your community based plastic surgeon. And yes this can be fixed. Take a look at my website: lidlift.com for examples of these repairs.
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CONTACT NOW Answer: Hard to tell from photos You appear to have minor ectropion from the photo. It is not clear if you also have chemosis. The eyelid specialist (oculoplastic surgeon) is probably correct in his/her diagnosis. A short course of steroids will not cause any problems, so you probably should use them as well as taping your lower eyelid upward. This is an easy problem to correct should it not resolve.
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CONTACT NOW Answer: Hard to tell from photos You appear to have minor ectropion from the photo. It is not clear if you also have chemosis. The eyelid specialist (oculoplastic surgeon) is probably correct in his/her diagnosis. A short course of steroids will not cause any problems, so you probably should use them as well as taping your lower eyelid upward. This is an easy problem to correct should it not resolve.
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April 3, 2014
Answer: Ectropian Your pictures demonstrates an early ectropian. This has resulted in downward pull on your lower eyelid and exposure of the white portion of your eye. In the early post-operative period, ectropians can be managed conservatively with massage and eyelid taping to support the lower eyelids. In most cases the lower eyelids will snap back and patients will have total resolution of their problem. When lower lid drooping persists after a suitable period of time has elapsed, surgical correction may be necessary. This problem requires close monitoring by your surgeon. In some cases consultation with an expert in eyelid reconstruction may be necessary.
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Answer: Ectropian Your pictures demonstrates an early ectropian. This has resulted in downward pull on your lower eyelid and exposure of the white portion of your eye. In the early post-operative period, ectropians can be managed conservatively with massage and eyelid taping to support the lower eyelids. In most cases the lower eyelids will snap back and patients will have total resolution of their problem. When lower lid drooping persists after a suitable period of time has elapsed, surgical correction may be necessary. This problem requires close monitoring by your surgeon. In some cases consultation with an expert in eyelid reconstruction may be necessary.
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April 26, 2009
Answer: Early ectropion Scared, Your photo shows that you have an early post operative ectropion. At this early stage, the condition can be and usually is easily corrected. Correction involves taping the lid up, massaging the lids, and sometimes even a temporary stitch to bring the lids into closer approximation. Whichever method is chosen, you should have frequent contact and follow up with your surgeon to monitor the progress of the correction. Good luck!
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Answer: Early ectropion Scared, Your photo shows that you have an early post operative ectropion. At this early stage, the condition can be and usually is easily corrected. Correction involves taping the lid up, massaging the lids, and sometimes even a temporary stitch to bring the lids into closer approximation. Whichever method is chosen, you should have frequent contact and follow up with your surgeon to monitor the progress of the correction. Good luck!
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July 17, 2017
Answer: You have ectropion after Blepharoplasty Chemosis is swelling and puffy fluid filled tissue on the white part of the eyes (sclera). Chemosis is a sign of irritation that is caused by drying of the eye that is due to the ectropion. Inadequate coverage of the eye by the drooping of the lower eyelid causes dryness and irritation of the eye which causes the chemosis. At three weeks, you need support of the lower eyelid. If taping with steri strips does not adequately support the lower eyelid, then I would place a stitch in the corner of the eyelids to pull the lower lid up to protect the eye. This is called a temporary tarsorraphy. You need intervention now. If your doctor does not want to address this, then you need to see an eyelid specialist--either an experienced plastic surgeon or an occuloplastic surgeon. You need intervention soon--in the next few days. Meanwhile keep your eyes moist with a lubricant like lacrilube 3-4 times a day (you can buy over the counter at a drugstore) and tape an eye patch over each eye at night when you sleep to help keep the lids closed.
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Answer: You have ectropion after Blepharoplasty Chemosis is swelling and puffy fluid filled tissue on the white part of the eyes (sclera). Chemosis is a sign of irritation that is caused by drying of the eye that is due to the ectropion. Inadequate coverage of the eye by the drooping of the lower eyelid causes dryness and irritation of the eye which causes the chemosis. At three weeks, you need support of the lower eyelid. If taping with steri strips does not adequately support the lower eyelid, then I would place a stitch in the corner of the eyelids to pull the lower lid up to protect the eye. This is called a temporary tarsorraphy. You need intervention now. If your doctor does not want to address this, then you need to see an eyelid specialist--either an experienced plastic surgeon or an occuloplastic surgeon. You need intervention soon--in the next few days. Meanwhile keep your eyes moist with a lubricant like lacrilube 3-4 times a day (you can buy over the counter at a drugstore) and tape an eye patch over each eye at night when you sleep to help keep the lids closed.
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