What causes my scleral show? (Photo)

Question

I thought my scleral show was caused by only my eyelids, but it is a bone issue. I thought it was maxilla, so I looked into maxilla surgeries and I was wrong again. What type of surgery do I need and what bone is causing my scleral show? When I come in for surgery what bone should I tell my surgeon to focus on? Is it a midface and cheekbone issue, if so what is going to be happening to the midface and cheekbones?

A.J. Amadi, MD · Answer

Dear lolllllllloooooolllll
You have a "negative vector" eye which is leading to lower eyelid retraction. The underlying anatomic features that are contributing to "negative vector"  lower eyelid retraction (inferior scleral show) are:
1. Slightly under-projected maxilla which doesn't provide enough support to the lower eyelid
2. Mild Exophthalmos (bulgy eye) that allows the lower eyelid to tuck underneath a slightly bulgy eye. Think of someone with a big belly who wears jeans...due to the over projected belly, the waist band of the pants tucks underneath the belly rather than above it.

The are a couple surgical options:
1. Using an implant on the cheek/eye socket to help get the eyelid have better support
2. Using a graft on the inside of the eyelid to help lengthen the height of the eyelid and push the eyelid up to cover the eyelid up. (Think of getting extra big pants to pull over the big belly).

Your best option is to consult an Oculofacial plastic surgeon (Oculoplastics surgeon) who has significant experience treating thyroid eye disease, a condition which creates the above anatomic changes, which can also be inherited (genetic).  See link below for additional information.

What causes my scleral show? (Photo)

Answers (1)

Recommended reading

Everything you need to know about Eyelid Surgery

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

What causes my scleral show? (Photo)

Answers (1)

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

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