Blepharitis and dry eye. Is it ok to proceed with lower eyebag and upper lid surgery next week? (Photo)

Opticians are not trained to diagnosis blepharitis or dry eye.  Do you mean your optometrist?  Your eyelid surgeon should throughly work you up for dry eye prior to performing eyelid surgery.  Many eyelid surgeons have absolutely no training for this and lack the basic training, experience, and equipment (slit lamp microscope) for evaluating dry eye.  If that is the case, an ophthalmologist (an eye m.d.) should assess you prior to surgery.  As a board certified ophthalmologist and fellowship trained oculoplastic surgeon, I see many patients who I advise not to have eyelid surgery because it will make their dry eye worse.  Did your potential surgeon even address dry eye with you?  I also wonder what type of lower eyelid surgery this surgeon is planning?  You have bilateral upper eyelid ptosis which is not corrected by cosmetic blepharoplasty.  I think you are raising significant questions that must be answered prior to having eyelid surgery.  I strongly recommend that you go with your gut feeling and get your dry eye situation before having what might be a catastrophic worsening of your eye status.  Remember that some individuals simply should not have eyelid.  You need surgeons who are motivate to do the right thing for you.  If you are uncertain of this, do not go forward with surgery.

Dear InsanelysilverThank you for your question and photos!  If you have acute dryness, surgery on or around your eyes can make this worse.  As long as you are prepared to use moisturizing drops and have these symptoms and your surgeon is going to manage this - you are assuming that risk.With Warm RegardsTrevor M Born MD

Conventional wisdom would say that if you are having acute issues with dry eyes, caution is advised.  However, this decision can only be reached between you and your Surgeon.  Xerophthalmia is more closely associated with upper eyelid surgery. However, should you experience a complication such as chemosis or ectropion (lower lid droop) after your procedure, you will be very uncomfortable. Since you have placed your trust in your Surgeon, please sit down and have another conversation.