Complicated Lower Eyelid Surgery
The results you show demonstrate a postoperative change in eyelid position that can indeed cause difficulty with vision. There may be incomplete closure of the eyelids with resultant dryness that alters the tear film and vision. You may also be using lubricants to keep the surface of the eye moist, which can also leave your vision blurred.
Unfortunately, treatment of this problem can be complex, and I agree that the best option at this point would be to see an oculoplastic surgeon in your area. I would suggest Dr. Jeffrey Nerad as an excellent person to consult with in Cincinnati.
3 Months after Blepharoplasty
The postoperative picture shows some degree of lid retraction and scleral show, which appears more prominent in the left eye. Some patients have scleral show and poor cheek support preoperatively, making the lower lid procedure more challenging and prolonging the recovery from the procedure. The lid retraction can also interrupt tear film mechanics in your eyes, leading to a sense of blurred vision. I would recommend frequent use of artificial tears and close follow up with your Surgeon. The vast majority of board certified Facial Plastic Surgeons and Plastic Surgeons are interested in your smooth recovery and satisfaction with the procedure. Assuming your procedure was not performed in a branded surgical mill, I would expect your concerns to be addressed.
Hanging lower eyelids 3 months after Blepharoplasty require expert treatment
The hanging lower eyelids are called Ectropion and can lead to dry eyes and corneal damage. You need to be using some form of lubrication to prevent the eye from drying and your doctor should see you and make sure your eyes are not too dry.
Some form of surgical intervention may be required at this point. A procedure called a Temporary Tarsorraphy can temporarily help re align the lower eyelid to a proper postion. In some cases a more permanent solution such as a lateral cantoplasty or lid shortening procedure may be required.
You need to see an expert who is experienced at Eyelid Surgery
You would benefit from an oculoplastic examination.
You may not have needed reading glasses until now but this does not mean that your eyelid surgery is the reason why you know need reading glasses. Oculoplastic surgeon are board certified ophthalmologists who are also fellowship trained in oculofacial surgery. They are uniquely trained to assess both the results of your eyelid surgery and its possible impact on your reading vision.
Vision Problems after a Blepharoplasty
Your photograph shows retraction of both lower eyelids. This leads to dryness of the eyeballs and can cause your vision to decompensate. At the very least you need to be lubricating your eyes with artificial tears. I am sure that your surgeon is interested in your quick recovery. It is possible that you will need to have a surgical correction to restore your appearance and your vision. Have a discussion with your surgeon and ask his or her opinion. If you do not receive a satisfactory answer, I would recommend that you have a second opinion with an Oculoplastic Surgeon.
Vision changes after Blepharoplasty
You didin't mention if your lower eyelid surgery, Blepharoplasty, was performed through the outside or inside of your eyelid. If your lower eyelids are low or malpositioned after the Blepharoplasty and your vision has changed, IMHO, you should be seen by an occuloplastic surgeon to have this evaluate and possibly treated. It's much easier to treat lower eyelid malposition early in the post op phase than it is once everything is healed and scarred down.
Vision can be affected by eyelid surgery because of dryness
There are 2 issues here. 1 is that the vision issue can be related (in the short term) to surgery because dryness can cause some visual changes and sometimes a slight change in prescription. The reading glass issue is probably unrelated to the surgery and you have just become more aware of visual problems afterward. Because you are 50, this problem will probably stay the same or get continuously worse and is unrelated to the surgery. The pockets and swelling are related to the surgery. The smas lift requires lifting of soft tissue and can result n many months of swelling in the area. Sometimes digital massage and lymphatic massage can be helpful. When you are massaging the liquid fluid toward the ears or from the pull down lid, massaging upward can be helpful. I would try to get a second opinion during the healing phase to see if there are conservative measures (such as massage and lymphatic massage) that can be taken.
Vision Changes After Eyelid Surgery
You should see an oculoplastic surgeon to evaluate your lower eyelid position. This may require revision surgery. Sometimes changes in eyelid position can cause changes in your glasses prescription (or cause you to need glasses when you didn't before). Changes in eyelid position can also cause dry eye. Either of these could explain why you suddenly need glasses to read.