Hering law after ptosis surgery?

Question

I had ptosis surgery on my right eye 5 days ago. I am happy with the healing. My only concern is about the possibility of Hering law affecting my other eye. I did the phenylephrine test and it didn't unmask a latent ptosis. My right eye (the ptotic one) used to be really dry before surgery so I used eye drops. While the left eye doesn't seem to be dropping, now it feels quite dry compared to the other. I was wondering why this is happening and if my left eye could still in the future Thank you

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. The dryness of the left eye has nothing to do with surgery on the right eye; it is a coincidence. Try using artificial tears a few times per day and follow up with your doctor.Good luck,

Kenneth D. Steinsapir, MD · Answer

Herrings law ptosis has nothing to do with dry eye.  Dry eye is common and expected this early after surgery. Use the artificial eye drops recommended by your surgeon and let your eyelid heal.  Consider reposting with photographs if your issues persist.

John R. Burroughs, MD · Answer

Generally if you see Hering's law wherein a one-sided droopy eyelid when pulled upward or stimulated upward, with the phenylephrine eye drop test, then you will get the other eye to droop following correction of the one side.  I always recommend surgery for both sides if this occurs.  If your unoperated eye is staying up well then I wouldn't be concerned about it drooping anytime soon.  I do not know the details of why your first side drooped, but if the unoperated eye is stable once the operated side is at its final postoperative height then that is a great sign.  Now that your operated side is more open I would expect it to be more dry, but your unoperated side likely didn't change size at all, so its peculiar that it seems more dry now.  Sometimes the eyes work together sympathetically with one another in terms of tearing, irritation, dryness.  Keep using a good quality of artificial tears, and congratulations to you and your surgeon for surgical success.

Hering law after ptosis surgery?

Answers (3)

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