Will Bleph Effect Dry Eyes Problem?

Rob,
If you have dry eyes and you are considering blepharoplasty, it may be helpful to have an ophthalmologic exam prior to your surgery. While certain procedures can help, it is also possible that blepharoplasty could worsen the symptoms. Just make sure you explore all your options before having surgery.

Undergoing either upper or lower blepharoplasty can exacerbate existing dry eye symptoms. Before any plastic surgery is performed, a thorough evaluation by an ophthalmologist is warranted to assess the severity and possible cause of your symptoms. That will allow a dialogue between you and your surgeon about the safety of undergoing blepharoplasty. 

The fact is that a sizable minority of patients having functional upper lid Blepharoplasty in their 60's have some degree of dry eye issues.  The reason for this is that baseline tear production naturally decreases with age.  In fact, many patients present with what they describe as "wet eyes".  This relates to decreased baseline tear production, which stimulates occasional reflexive tearing.  Truly significant functional dry eye issues tend to occur in patients who have a) severe dry eye issues prior to surgery, b) upper lid skin resected at the time of surgery, or c) Both a and b.  My rule of thumb is that any patient who is able to wear contacts does not have dry eyes.  My second rule of thumb is that any patient who cannot make it for 3-4 hours without using artificial tears should probably not have surgery.  My third rule of thumb is that removal of upper eyelid skin should always be judicious (the "pinch" technique).  I concur with the advice above that any "dry eye" patient considering upper eyelid surgery should consult with an Ophthalmologist.

Eyelid surgery can aggravate dry eyes especially in the short term.  I have my patients see an ophthamologist prior to any surgery to evaluate the magnitude of the problem and the plan to treat problems if surgery is performed.  Occasionally the ophthamologist will advise against surgery.

Every eyelid surgery candidate should have a full ophthalmic exam prior to under going this rejuvenating procedure. As an Ocular Plastic Surgeon I examine and review several aspects of the patient's eyes prior to surgery.
It may not be enough for your cosmetic surgeon to only look at your eyes at a distance. The eyelids and eyes must be checked for several conditions that could effect your happiness in regard to your surgical outcome. Your physician must check the height, contour, and muscle strength of the lids. For example if your eyelids do not fully close prior to the procedure or the lid is weak or "floppy" you may have problems with tearing or irritation after the surgery.
The front of the eye, the cornea, must be healthy and this includes a good tear film. This can only be checked by a slit lamp exam. If your eyes are dry, you may still be able to have the procedure. If they are severely dry or you have corneal problems, you may end up with tearing problems.
After eyelid surgery more air can hit off the eye worsening a dry eye or corneal problem. It is very important for patients who have had refractive surgery (LASIK) to have an ophthalmic evaluation prior and these patients are more prone to tearing problems. One of the most important tests is a Schirmer test which can be used to predict a dry eye problem. Ocular Plastic Surgeons check all of these factors prior to perfoming blepharoplasty.