Good morning, I have symptoms of dry eye and my ophthalmologist told me they could be related to my scleral show due to a congenital lower eyelid retraction. Do you consider this diagnosis accurate? Is eyelid surgery a possibility? Thanks in advance.
December 6, 2019
Answer: Lower eyelid retraction Thank you for your photos. Your scleral show indicates that you do have a problem with lower eyelid retraction or lower eyelid malposition. The right technique to correcting this will depend on the cause of the retraction and the amount of tissue laxity you have in the area. Your dry eye should improve with correction of this, but it may not resolve it completely. Hope this helps!Johnson C. Lee, MD Board-Certified Plastic Surgeon
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December 6, 2019
Answer: Lower eyelid retraction Thank you for your photos. Your scleral show indicates that you do have a problem with lower eyelid retraction or lower eyelid malposition. The right technique to correcting this will depend on the cause of the retraction and the amount of tissue laxity you have in the area. Your dry eye should improve with correction of this, but it may not resolve it completely. Hope this helps!Johnson C. Lee, MD Board-Certified Plastic Surgeon
Helpful 1 person found this helpful
December 5, 2019
Answer: Could this be considered scleral show and lower eyelid retraction? Could it be related to my dry eye symptoms? Hello and thanks for the question! The tear production in our eyes comes from the lacrimal glands. The lacrimal glands are above the outer eyelid. The tears are produced laterally and they proceed across the eyeball every time you blink and finally drain into the tear ducts on the nasal end of the eyelid. For the tears to adequately lubricate the eyeball, the lids have to completely close. People with very prominent eyeballs, as opposed to patients with deep set eyes, are prone to having their eyelids open slightly as they sleep because it takes more eyelid to close the eye than if the eyes are more deep set. The muscles around the eye relax while we sleep and if the lid opens during sleep, the eyes can dry out. The lower lid retraction can occur congenitally as in your case or it can occur after lower eyelid blepharoplasty. When it occurs after eyelid surgery, it is usually due to a weakness of the muscles of the lower lid and can be repaired with a lid shortening technique. Your lid is obviously young and doesn't appear to have any laxity making a surgical repair much less likely. You will need to use your artificial tears during the day, protect the eye at night with Lacrilube ointment, and keep any air from drying you out such as a ceiling fan or air conditioner vent with a daytime sleeper mask. If the humidity is low, such as during cold weather when you turn the heater on, a humidifier will reduce the dryness. The diagnosis of scleral show due to congenital lower eyelid retraction appears to be correct. My Best!John Standefer MD
Helpful 1 person found this helpful
December 5, 2019
Answer: Could this be considered scleral show and lower eyelid retraction? Could it be related to my dry eye symptoms? Hello and thanks for the question! The tear production in our eyes comes from the lacrimal glands. The lacrimal glands are above the outer eyelid. The tears are produced laterally and they proceed across the eyeball every time you blink and finally drain into the tear ducts on the nasal end of the eyelid. For the tears to adequately lubricate the eyeball, the lids have to completely close. People with very prominent eyeballs, as opposed to patients with deep set eyes, are prone to having their eyelids open slightly as they sleep because it takes more eyelid to close the eye than if the eyes are more deep set. The muscles around the eye relax while we sleep and if the lid opens during sleep, the eyes can dry out. The lower lid retraction can occur congenitally as in your case or it can occur after lower eyelid blepharoplasty. When it occurs after eyelid surgery, it is usually due to a weakness of the muscles of the lower lid and can be repaired with a lid shortening technique. Your lid is obviously young and doesn't appear to have any laxity making a surgical repair much less likely. You will need to use your artificial tears during the day, protect the eye at night with Lacrilube ointment, and keep any air from drying you out such as a ceiling fan or air conditioner vent with a daytime sleeper mask. If the humidity is low, such as during cold weather when you turn the heater on, a humidifier will reduce the dryness. The diagnosis of scleral show due to congenital lower eyelid retraction appears to be correct. My Best!John Standefer MD
Helpful 1 person found this helpful
