Just had lower blepharoplasty 5 days ago and developed chemosis in both eyes. Left more than right. What can I do to help heal?

Question

My eyes are feel dry and irritated. I've been putting in drops of Thera Tears. I see my surgeon in three days but in the meantime is there anything I can do to alleviate the irritation. Also, I feel like I have "puppy dog eyes". They droop slightly at the ends. Will this disappear after my swelling has gone down?

Donald B. Yoo, MD, FACS · Answer

Chemosis occurs not infrequently after lower lid blepharoplasty.  It can be exacerbated if your eye is not well-lubricated.  Contact your surgeon's office, as he/she may want to start treatment with steroid eye drops and/or oral steroids, or other treatments (taping, temporary tarsorrhaphy, etc).

John J. Martin, Jr., MD · Answer

We think that this occurs because of disruption of lymphatic flow after the surgery.  The swelling of the conjunctiva will make your eye dry, so you will need to use a lot of artificial tears throughout the day.  You should also use an artificial tear ointment or gel at bedtime.  Your doctor may want to put you on an anti-inflammatory drop as well if the chemosis is pronounced.  If it does not resolve there are other things that can be tried such as pressure patching, temporarily closing the eye with sutures, or even draining the fluid.  It can be stubborn, but will eventually resolve!

Kenneth D. Steinsapir, MD · Answer

If your surgeon was not an oculoplastic surgeon, then they lack the training, skills, experience, and even the equipment needed to treat this condition.  Swelling causes chemosis but drying makes it persist.  Under these circumstances using an artificial year every 30 minutes during the day and a bland ophthalmic ointment like refresh PM at bed time is very helpful.  See you ophthalmologist for real help.

A.J. Amadi, MD · Answer

It depends on the severity of chemosis. For mild cases, lubrication [over the counter ointment is available, just ask your pharmacist to help] is usually enough. However for more severe cases, I may consider using steroid drops to help decrease inflammation.If not responsive to that over a couple of weeks, there are some other "tricks of the trade" that your Oculoplastic surgeon can try, such as compression eye patch.I would not start massaging [or other 'eye exercises'] this soon after surgery.

A. Joshua Zimm, MD · Answer

Chemosis is not that uncommon after lower lid blepharoplasty, with the incidence most frequently cited around 10% (although higher in other studies).  There are different drops you can be given to help with the swelling in addition to lubricants.   In addition, lower eyelid taping can be of benefit as well.  It almost always resolves but may take a couple weeks or longer.  I would contact your surgeon to see if they can give you some relief prior to your next visit.  Best of luck.

Lenore Sikorski, MD · Answer

Hi there,
I would see your doctor sooner than 3 days.  He or she can give you a stronger lubricant for your eyes and start you on eye exercises.
Hope this helps and good luck!

Just had lower blepharoplasty 5 days ago and developed chemosis in both eyes. Left more than right. What can I do to help heal?

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