Itchy, Burning Eyes 2 Months After Blepharoplasty

Dear Santa Barbara

Dry eye after blepharoplasty is well described.  Some eyelid surgeries are more aggressive than others and can cause more dry eye symptoms.  So while it is true that dry eye symptoms do generally settle down within 4 to 6 weeks, this assumes that an aggressive lower blepharoplasty was not performed.  These procedures can damage the muscle the helps blink the eyelids and helps close the eye.  Similarly an upper blepharoplasty generally has no bearing on eye comfort after this time period unless aggressive work was performed to reduce the redundant skin and muscle in the upper eyelid.  General ophthalmologists are not always a focused on corneal drying as they should be.  Certainly the recommendation of using drops twice a day is not that helpful.  Also the contact wetting solution is not optimal.  A cornea specialist will be much more attuned with you dry eye concerns and have a more comprehensive approach to making the eyes more comfortable.  

Most patients have some issues with dry eye after any eyelid surgery.  The glands that make our tears are located in the eyelid, and the inflammation of the surgery can alter the production of tears.  For that reason we recommend using an artificial tear at least 4 times a day.We lubricate the cornea with our blink which can be altered after the surgery.  This is especially true in people who have some lid retraction of the lower lid.  If you have that, it can take a while for the lid to return to a normal position.  Try using an artificial tear ointment at bedtime - this can make the eyes feel better throughout the day.  It may also be too soon to be wearing your contacts as they can be irritating to a dry eye. 

It's not unusual for patients to develop dry, burning, itching eyes following blepharoplasty surgery. In most cases, this problem resolves in 2 to 3 weeks, but in rare cases may persist for longer periods of time.A variety of factors can contribute to eye dryness. These include skin tightness, muscle weakness, ectropian formation and damage to the lacrimal gland. It's important to address these problems as soon as possible to avoid inflammation and damage to the cornea.The vast majority of patients respond to conservative management. This typically involves the use of drops and lubricants. In some cases, it may be necessary to use lacrimal plugs.It's important to maintain close contact with your plastic surgeon. If you fail to see improvement, it might be appropriate to consult an ophthalmologist as well.