When Eyelashes Are Being Pushed Downward, is Eyelid Surgery Medically Necessary?

For eyelid surgery to be deemed medically necessary, eyelid skin must actually touch the eyelashes or cause lash ptosis.  This is also known as dermatochalasis.  Most insurance companies require approximately 30% restriction of visual field, which must be documented by a visual field obstruction test.  Pictures will also be required.  Chart notes and preauthorization is all done prior to upper eyelid surgery.  

Some of the criteria that insurance companies are looking for are:  excessive skin weighing down the eyelids, patients having to look at their eyelids skin and/or eyelashes in primary gaze.  Recurrent skin irritation from excessive upper eyelid skin.  Marginal reflex distance; the distance from the light reflex from the camera to the lower limit of the upper eyelid margin and their results on visual field testing.