How to help lymphatic drainage presenting as chemosis after lower eyelid surgery? (Photo)

Question

Chemosis in left eye & its 25 days after surgery. It's the same eye as the burst stitches which have healed quite nicely. Am using over the counter artificial tears & taping my eye 24/7. If I don't my eye tears-up, goes very inflamed & exceedingly photo sensitive. I occasionally massage gently and smile (20x) using eye muscles about 3x a day. Photo shows it without tape ( just removed) & lubricated for about 15 minutes. Is there anything else I can do to aid the situation?

Kenneth D. Steinsapir, MD · Answer

The right lower eyelid malposition is due to a motor nerve injury caused by the eyelid surgery.  We can tell you to be patients and that things will get better.  This is true but it is unlikely to heal to a point were you will fully satisfied with what you are looking at.  The reason you have chemosis is not from lymphatic disruption which is likely to be contributory, it is from drying.  The injured eyelid does not adequately protect the eye and move tears around.  This causes more drying than normal.  This results in secondary conjunctival inflammation.  Because you are photosensitive, it is also likely that you have corneal drying.  I strongly advise you to be assessed by a cornea specialist or general ophthalmologists.  More aggressive lubrication of the cornea is sometimes very helpful.  This might be around the clock use of a bland opththalmic ointment.  Occasionally 24 or 48 hours of patching helps the chemosis to settle down.  I would be very careful about using a steroid drop without the direct supervision of an ophthalmologist.  These drops can be useful but they also can raise intraocular pressure.  Do not let your surgeon perform a lateral canthoplasty to address this situation unless this is a core aspect of their practice (i.e. board certified ophthalmologist fellowship trained in oculoplastic surgery).  The problem is that you have a large eye.  Shortening the lower eyelid will actually exacerbate where the lower eyelid rides on the eye and pull it even lower.  These well meaning but failed efforts use up needed resources for definitive repair.

Bryson G. Richards, MD · Answer

Thank you for your picture and question. It appears that one of your lower eyelids sits lower than the opposite side. Not sure if this picture was taken in a mirror. Ask your surgeon about steroid eye drops. They can really help to resolve chemosis. As for the picture, it appears that you have laxity in your lower eyelid. This appears to be an early sign of ectropion. Talk with your surgeon about massage. Also, you may likely need a revision to cinch up the lower lid.I hope this helps.- Dr. Bryson Richards

How to help lymphatic drainage presenting as chemosis after lower eyelid surgery? (Photo)

Answers (2)

Recommended reading

Everything you need to know about Lymphatic Massage

Our mission is to create a world where every investment in modern beauty is Worth It.

How to help lymphatic drainage presenting as chemosis after lower eyelid surgery? (Photo)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Lymphatic Massage

Our mission is to create a world where every investment in modern beauty is Worth It.