Why does eyelid surgery cause dry eyes?

Question

I had eyelid surgery 25 yrs ago and need it again. I do have dry eyes, probably due to medications that I take. Will having another surgery make the dry eye worse. I am thinking maybe a brow lift would be better. My surgeon is willing to do one procedure or both.

Mehryar (Ray) Taban, MD, FACS · Answer

Most eyelid surgeries, if done safely and conservatively, will not affect eye closure, blink function, and tearing system, without causing any dry eyes. However, if eyelid surgery is done aggressively where it affects eye closure and blink adversely, then that lead to the eyeballs being exposed to air more, which in turn causes dry eyes.  It is important to see a specialist (oculoplastic surgeon).

John J. Martin, Jr., MD · Answer

There are a few reasons for increased dryness after an eyelid surgery.  During the surgery, excess skin is removed, and some of the muscle responsible for blinking and closing the eye will also be excised. The eye will also be a little more open, so will be a bit more exposed to the air.  Almost every patient will experience some dryness after the surgery.  In most people this is tolerable, and can be treated with artificial tear drops.  In an occasional patient, this dryness can persist and be very irritating.  If you already have a dry eye, you may have more issues with this post-op.  A browlift will usually not cause as many problems with dry eye unless a very aggressive lift is performed, which can prevent normal eyelid closure.

Kenneth D. Steinsapir, MD · Answer

Of course, being 25 years older also contributes to dry eye.  While upper blepharoplasty will be more likely to contribute to dry eye than forehead lift.  However, have the surgery you need.  If you symptomatic from your dry eye, you may not be a candidate for either surgery.

Barry L. Eppley, MD, DMD · Answer

Dry eyes can occur after blepharoplasty surgery because the procedure may interfere with the speed and completeness of the blink reflex of eyelid closure. Those patients who are at greatest risk are those that have dry eyes beforehand and are getting both upper and lower eyelids done. The safest approach would be a browlift if that would provide an adequate amount of aesthetic improvement.

Steven Wallach, MD · Answer

Multiple factors go into developing dry eye. Surgery on the eye may affect tear production, and the eye may be exposed with upper lid skin excision, it may also be genetic disposition for some people as well.

Why does eyelid surgery cause dry eyes?

Answers (5)

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