No Dramatic Vision Changes After Upper Eyelid Surgery

Eyelid surgery can cause persistent dry eye issue that may affect your ability to wear a contact lens. Your general ophthalmologist should be able to assess this issue. If they are unable to resolve the issue, I recommend that you see a cornea specialist.

There are several possible reasons for your changing prescription. Dry eye syndrome can affect the vision and could be present after lifting the eyelids. In some cases,I have seen a change in the prescription after ptosis repair. I would recommend seeing your contact lens specialist to determine if the eyelid is affecting the movement of the contact lens.

From your description it seems like you had ptosis surgery.  But this is not surgery to change your vision.  Did you mean visual fields??  Regardless, if you are having trouble seeing, you should see an opthomologist.  I'm sure your plastic surgeon will be able to refer you to someone if you don't have one.

Dr. Cat Begovic M.D.

Although it would be helpful to see photos and know what operation you actually had done, I think I can answer your question.

I think you either had an upper blepharoplasty or a eyelid ptosis repair. 

A blepharoplasty can be a procedure covered by insurance if there is skin overhanging the eyelashes and physically blocking your visual fields.   It involves removing the excess skin from the upper eyelid.  There is no surgery on the eye itself.   The benefit is removing the physical block from the upper visual fields.

Repair of ptosis is also sometimes covered by insurance.  This often involves removing skin as well, but the primary goal is to reposition the whole upper lid in relation to the pupil.   This is also a mechanical problem in front of the eye. 

In neither case should you expect a change in your visual acuity.  Unless you also had an operation on your eye itself, ie lasik, cornea transplant, glaucoma procedure, at the same time, your vision should not change.   Your prescription for your glasses is independent on the operations on your eyelids, and is not related.

I would recommend speaking with your surgeon and your ophthalmologist about these issues.

This is a very rare issue after Blepharoplasty and the visual changes could be due to dry cornea or swelling changing the cornea shape.  If you have had a thorough exam by an opthalmologist to rule out cornea and retinal issues, I'd wait it out.  The odds are that your vision will return to what it was before the Blepharoplasty.

Dear Dan,

You are not alone with this problem, and although rare, is well documented in the medical literature.  Raising a drooping eyelid lifts the pressure off the cornea, which plays the most important role in the refractive (focusing) power of your eye.  Usually these changes in prescription are temporary if they happen, and usually stablize by three months.  This is particularly an issue if someone has had Lasik surgery before their eyelid surgery.  Your gas permeable contact lenses may be a problem, as there can be fluctuations in the fluid content of the cornea over the course of a day that affect your prescription.  These issues have to discussed with your eye doctor, and hopefully your prescription will stabilize soon.

Good Luck,

Yoash R. Enzer, MD