Droopy Eyelid After Strabismus Surgery, Do I Need Surgery?

Question

I had strabismus surgery on only my left eye 4 weeks ago. The alignment is fine now, but what I didn't expect is that now my eyelid droops. My eyelid feels like there is a weight on it that prevents me from lifting the lid all the way up. I did not have this problem before. Is this likely permanent? Would a blepharoplasty fix this? I had a previous strabismus surgery 25 years ago, and DID NOT have droopy eyelids afterwards.

A.J. Amadi, MD · Answer

In order to gain exposure to the extraocular muscles, an eyelid speculum is used to open the eyelids maximally. As mentioned previously, this could stretch the eyelid muscle and exacerbate its disinsertion.

	If this hasn't resolved 3 months after surgery, I would recommend a consultation with an Oculoplastics surgeon. There are multiple ways to address eyelid ptosis and only an in-person consultation can give you the information needed to make an accurate recommendation.

	Best of luck

Larry S. Nichter, MD, MS, FACS · Answer

Ptosis, or droopy eyelids, can occur after strabismus surgery for a variety of reasons. This problem may be related to edema and if so will go away on its own, so I recommend waiting 1-3 months to see if the issue corrects itself. If not, you should have a consultation with your Oculoplastic surgeon to see if you are a candidate for surgery.

Mehryar (Ray) Taban, MD, FACS · Answer

It is difficult to assess without a photo or examination, but ptosis (droopy eyelid) can occur after any eye surgery, for various reasons. You should wait at least another month before deciding on surgery as things can change. See an oculoplastic surgeon for surgical options.

Sam Goldberger, MD · Answer

Droopy eyelids after strabismus surgery can happen. I personally like waiting 6 months before performing any surgical correction because ptosis (droopy eyelid) sometimes resolve when swelling goes away. A blepharoplasty will probably not fix this, most likely you will need a ptosis repair. See an Oculoplastic surgeon so he can evaluate the droopy eyelid.

Louis W. Apostolakis, MD · Answer

I would agree with Dr. Schuster, however, I would tell you that after 4 weeks this problem may yet correct itself. Their may be swelling or some temporary injury to the muscle. If it fails to correct after several months, ptosis repair is a relatively straight forward surgery without a great deal of recovery and a high success rate.

Steven Schuster, MD, FACS · Answer

When strabismus surgery is done a retractor is used. If you have a slight weakness in the levator muscle it can be increased. This may result in a slight drooping or ptosis. It is a very rare occurence but can occur. The treatment if that is the case is a levator repair. This corrects the ptosis. Discuss this with your opthalmologist to see if this is the case and would help you. Good luck, Dr. Schuster in Boca Raton.

Droopy Eyelid After Strabismus Surgery, Do I Need Surgery?

Answers (6)