Correcting scleral show which causes dry eye symptoms. (photo)

Question

I'm 30 years old , I never had a surgery. I had tear trough filliers. You can see from the attached pic that I have a slightly scleral show in my eyes. I just want my lower eyelid to be less droopy and be more horizontal. The white part is getting wider each year (specially for the right eye in the pic). and it caused dry eye symptoms. What is the best procedure for my case?

Thomas A. Mustoe, MD, FACS · Answer

You need a careful exam to rule out causes for proptosis (principally thyroid disease). The scleral show can be correct surgically: The type of procedure (canthoplasty versus a more involved procedure) could only be determined on physical exam.   The procedure would slightly change the shape of your eye, and should be very cautiously considered.  It is much more commonly encountered as a complication of lower blepharoplasty.

Manish H. Shah, MD, FACS · Answer

Hello damindra,Thanks for your question.I would recommend a physical exam with your physician to rule out medical conditions that can involve the eye, like thyroid disease.If you have no medical issues, surgical elevation of the lateral lower lid can be considered.You appear to have a negative vector to your lower lid position but this is best seen on lateral view.  If this is the case, as you normally lose bone in your lower orbit, the lid gets pulled down around the curvature of the eyeball worsening the scleral show because the bone drops and recedes into the orbit..A canthal suspension procedure, can improve the lateral rounding of the lower lids and close the lateral commisure of the eye.  Occasionally orbital rim implants are used to change the vector of the lower lid to a more neutral position, allowing for less downward traction on the lid by the normal suspension structures.I would recommend seeing an oculoplastic surgery specialist in your area for a thorough exam and to develop a safe surgical plan.Good luck,Dr. Shah

Matthew Hansen, MBBS, FRACS (retired) · Answer

Thankyou for the question and picture. You appear to have some proptosis and lid retraction which can be due to a variety of underlying conditions particularly thyroid problems and you should have this checked out before considering any surgery. If there is an underlying thyroid problem that must be dealt with first. Correction of proptosis and lid retraction or scleral show is difficult but there are options that you could discuss with an experienced plastic or oculoplastic surgeon.

Andres Gantous, MD - Account Suspended · Answer

First of all, you should have a proper medical checkup in order to rule out any possible medical conditions that could be leading to having an incremental scleral show. It is difficult to tell from one photo, but you could be suffering from some proptosis where your eyes are bulging out a bit. If you are cleared medically, there are a variety of lid tightening and repositioning procedures that can help correct the problem. A surgeon with oculoastic experience can provide you with proper advice after examining you. Hope his helps.

Correcting scleral show which causes dry eye symptoms. (photo)

Answers (4)

Answer: Scleral show

Answer: Scleral show

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Correcting scleral show which causes dry eye symptoms. (photo)

Answers (4)

Answer: Scleral show

Answer: Scleral show

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Everything you need to know about Eyelid Surgery

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