Why Has my Vision Deteriorated After Eyelid Surgery?

Question

I had an incision at the top of each eyelid and the muscle was reattached to open the lid further. 6 months later my vision is awful. My optometrist thinks that the change in eyelid posistion has caused the corneas to change shape and they continue to do so. I have had multiple lense changes both in type and prescription. I wore gas perms with only minor changes for 40 years.I now have a toric lense in the left eye that does not work and none in the right in hopes it will stabilize.Any ideas?

Sean Younai, MD, FACS · Answer

As I have also experienced it with my own patients it is possible to see a change in the eye prescription after eyelid surgery. I don't know exactly what are the causes of it, but I know that it can happen and I educate my patients about this phenomena.

Manu Gujrati, MD · Answer

It is fairly common to have temporary vision changes after blepharoplasty (eyelid surgery), especially if both the upper and lower lids are operated on at the same time. As with any surgery, swelling occurs during the healing process. When that swelling occurs in the eyelids, some slight and minor pressure is placed on the eye itself. The orbital bone (commonly known as the &ldquo;eye socket&rdquo;) is a tight space, so when the swelling from eyelid surgery pushes back on the eye, the eye itself temporarily changes in shape. It actually becomes shorter, which directly affects the focal distance of your vision. As the swelling starts to go down, the eye will return to its normal shape and your focus will recover as well.

	Another issue that can affect contact wearers is increased dryness of the eyes after blepharoplasty which can severely affect the patient's ability to tolerate wearing lenses and maintaining clear vision with them in.

Kenneth D. Steinsapir, MD · Answer

No doubt your optometrist is a very nice and well meaning individual.  However it is absurd to speculate on something like this.  An induced astigmatism is very easily measured with corneal topography.  Many optometrists have this technology.  However the cornea speicalist went to medical school and was academically successful to obtain a residency in ophthalmology.  By comparison, the optometrist did not go to medical school.  Part of what you get is brain power when you see the cornea specialist.  My guess is that your eye lid surgery is affecting the ability of your eyes to support the contact lens.

Joseph A. Eviatar, MD, FACS · Answer

Sometimes you can get vision changes after eyelid surgery. If there are some subtle vision changes, within 3 months they usually settle down. But, sometimes they can take longer and you may get a change in the prescription. It’s also possible that it is unrelated to the surgery and just coincidental. It all depends. Based on the shape of the cornea and astigmatism, you can tell if the change is related to the eyelid, or if the vision changes are related to the lens or something else.

Francis R. Palmer, III, MD (retired) · Answer

Visual changes after Blepharoplasty (eyelid surgery) have been reported but in over 20 years, I've only had 1 patients in whom the vision change required glasses (contacts actually) to correct the vision and this ultimately resolved within 3-4 months. I would guess that the lymphatic drainage caused by the Blepharoplasty causes swelling and edema, of the cornea, that can last longer in some patients than others. Typically, the vision returns to normal within a few days. As long as an opthalmologist doesn't see any permanent changes in your cornea and retinas, you should be reassured. Hopefully, your vision will retuurn to normal soon.

Why Has my Vision Deteriorated After Eyelid Surgery?

Answers (5)

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