Is the only way to correct horners with an eyelift, or can the eyeball sinking back actually be fixed too? (Photo)

Question

I have horners as a result of a surgery and you can see that my right eye is tucked back a little as well as ptosis. Is it possible to fix the eye itself or only a lift to fix the ptosis

Kenneth D. Steinsapir, MD · Answer

There is a list of issues that can cause a traumatic horner's syndrome. Generally, the ptosis is correctable with a conjunctival Muellerectomy.  However, there is also a pupil abnormality associated with the Horner's syndrome and this cannot be corrected surgically.  I recommend you see an oculoplastic surgeon to have this assessed.

Amiya Prasad, MD · Answer

Your situation requires a full examination before you get a more comprehensive
answer as it depends on the type of surgery you had that led to the Horner’s Syndrome.
If you had some intracranial or neurosurgical procedure that led the eye to be
pushed, then it has to do with the bones around the eyes called the boney orbit.
The reconstruction can be very complex and may require a team approach that
includes an orbital oculoplastic surgeon and a neurosurgeon in order to achieve
the restoration and the position of the eye, which may or may not be practical.

As a practicing oculofacial plastic surgeon in Manhattan and Long
Island for over 20 years, patients who have enophthalmos or eyes pushed inwards
and exophthalmos where the eye is pushed out like patients with Grave’s Disease
or thyroid eye disease, we always have to think practically. Our goal in every
procedure is to always reduce risk. Eyelid surgery alone is a reasonable
compromise because trying to achieve ideal may involve more risk. For patients
with thyroid eye disease that have eyes that are bulging out with one eyelid particularly
high, I would offer the option of just bringing that eyelid down. That’s not a
simple procedure but it is less invasive than doing an orbital decompression.
After the procedure, patients are more satisfied because the eyes are more
symmetric than before and a classical approach is necessary. My goal is to deal
with individual situations and balance risk and benefit.

In your situation, I think more a detailed examination is
necessary.  This should be brought to the
attention of an oculoplastic or orbital surgeon. If you
had neurosurgery as I described, then it is something that you should also
discuss with your neurosurgeon on how to get a normal eye position. The
challenge now is when the eye recedes back, a lot of scar tissue may form,
making it very difficult to place the eye in a normal position even with the
correction of the structure around the eye. It may still be more practical to
have ptosis surgery to get the eyelid in a more naturally symmetric position.

Whenever an individual has a problem like yours, patients always think
that everyone’s looking at them sees that asymmetry, but I always tell them
that people look at you globally. If you are able to create some balance even
with one or two millimeters of correction, then everything else averages out
and blends and becomes camouflaged.

I suggest that you meet with some doctors and the specialties I
described so that you can get more information. You may need imaging studies.
You also may need to figure out whether or not a more complex surgery in the
orbit is necessary versus a more straightforward surgery that we routinely do
in our office. Whether or not it’s to lift the eyelid or bring the eyelid down,
it’s considerably less risky. Once you have your information, move forward with
whatever you’re comfortable with. I hope that was helpful, I wish you the best
of luck, and thank you for your question.

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Is the only way to correct horners with an eyelift, or can the eyeball sinking back actually be fixed too? (Photo)

Answers (2)

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Is the only way to correct horners with an eyelift, or can the eyeball sinking back actually be fixed too? (Photo)

Answers (2)

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Everything you need to know about Ptosis Surgery

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