What Causes Blurry Vision After Blepharoplasty?

It is important that you have your eyes examined. Normally, after belpharoplasty, you may have blurry vision from the ointment used to keep your eyes moist. You may then need to continue to use moisturizing drops to keep the eyes from becoming dry. Sometimes during surgery or after surgery when your eyelids are not yet protecting your eyes properly, you may get a corneal abrasion which can cause pain. However, for your vision to still be blurry three weeks after surgery is not typical. It is important that you have your eyes examined by an ophthalmologist/specialist to ensure that nothing more serious is occurring. It may seem excessive, but you don't want to mess around with your vision.
I hope this is helpful.
David Shafer, MD
Shafer Plastic Surgery
Manhattan

There are many factors that can cause blurred vision after eyelid surgery. Given the history of blurred vision starting one week after blepharoplasty the most likely cause is a dry eye or poor closure of your eyelids. If you did not have the luxury of having an Ocular Plastic Surgeon perform your surgery, I agree with the others that now is the time to be examined by one or an ophthalmologist. The Eye MD needs to look at your cornea at a slit lamp and your nerve in the back of your eye with an ophthalmoscope.
If your eyes are just adjusting to being more open than artificial tear drops (preservative free) every 2 hours and lubricant ointment at bed time will help. I also suggest the use of a cool mist humidifier at bedside ( especially now with the heat coming on). If your lids do not fully close, the same regimen may make you comfortable but other measures may need to be taken.
Best of Luck,
Mark Berkowitz, MD

Changes in visual acuity are not uncommon following blepharoplasty. There are several possible causes for changes in vision following this type of surgery. These can include the use of ointments following surgery, dry eyes following surgery and eyelid skin tightness which can change the curvature of the cornea.

Blurred vision can result from the use of topical ointments which are used for a variety of reasons in the post-operative period. In our experience, the use of eye ointment is the most common cause of blurred vision following blepharoplasty. For these reasons, we recommend the use of ointment at night and drops during the day.

Eye dryness following blepharoplasty can also contribute significantly to vision changes following this type of surgery. This is typically treated with eye lubricant. Usually, eye drops are used during the day, and longer lasting ointments are used at night.

Finally, tightness of the eyelids against the globe can affect the curvature of the cornea and cause refractory changes. This can be made worse when significant swelling is present.

When vision changes occur following blepharoplasty, it’s appropriate to consult an ophthalmologist. With appropriate management of these symptoms, vision usually returns to normal in a matter of weeks.

I agree with the excellent recommendations of my colleagues.
However, I do experience similar complaints in some of my patients at the 3 week period. Wound healing does result in some sensations of tightness which is due to scar tissue formation. Although you may not realize it you may not be completely closing your eyes at night resulting in drying of the cornea. Usually the gel prevents this. The most common sign of this is dryness and itching which is worst first thing in the morning.
Furthermore, if this is the cause this is likely to ease up over the next few weeks.
Overall, it is in your best interest to see an opthalmologist. If the symptoms are due to cornea dryness they can see this will special dyes and lights and confirm the diagnosis.
Avoid the gel or lube during the day. It is specially formulated to last all night long but it can cause blurred vision. Saline drops are bothersome because they need to be instilled every 2 hours but they do not tend to blur vision.

Blurry vision shortly after surgery is very common. The swelling is often the result of edema in the cornea essentially creating a temporary "bad contact lens". Ointments can of course cause blurriness as well, especially the thicker ones often prescribed for use at nighttime. However these sources of blurriness almost always improve shortly after surgery, and your blurriness seems to be getting worse.
Dryness can lead to corneal injury and eventually corneal damage, so it would be highly recommended for you see an opthalmologist to evaluate for this condition. Chemosis is a swelling condition that can cause blurriness. There are specific eyedrops to use for this condition. Sometimes surgery, especially on the canthus, can cause differential pressure on the globe and a change in the refraction of the eyes (i.e. when bulging eyes are made less bulging by canthal surgery. Even eye pressure can change, especially when patients use the steroid drops commonly prescribed after eyelid surgery. All these conditions would warrant specific and different treatments.
Bottom line you should see an ophthalmologist.

This can be seen quite often due to different factors. Usually the antibiotic ointment is a culprit early on. Next, dryness of the eyes after overzealous skin removal can happen as well causing blurry symptoms. Finally, a change in eye prescription. May occur as well as the weight of the eyelids has now come off the eye and the shape of the eye may be changing. I would recommend consulting an eyelid or eye expert for the blurry vision. 

During the course of a blepharoplasty, your surgeon may place
some ointment in the eye. In the
immediate postoperative period this ointment can lead to blurry vision. This is normally resolved in the first
24 hours.

















After any type of eyelid surgery
it is possible that the cornea may be swollen distorting the lens apparatus of
the eye, leading to some temporary visual disturbances. As swelling subsides, this problem will
go away. If the cornea itself was
scratched during the course of the procedure there will be associated pain and
possible visual disturbance. This
diagnosis can normally easily be made and appropriate treatment will resolve
the problem, normally within 24-48 hours.

There are several causes of vision change after blepharoplasty:

1. Dry Eyes: This is second to eyelid closure problems or incomplete blinking. This gets better with time most often. I have patients use drops during the day (up to every hour sometimes) and gel at night.  If your eyes are dry, increase the lubrication. You cant overdose it

2. Refractive changes: Sometimes after blepharoplasty or ptosis surgery, astigmatism can be induced in the cornea as the eyelid position is slightly changing on the surface on the cornea. This is usually temporary but may be permanent and may need to change your glasses prescription.

3. Postoperative bleed and hemorrhage: a Hemorrhage behind the eye can put pressure on and damage the optic nerve. It is usually sudden, accompanied by pain, the eye builging and immediately in the postoperative period. This sounds less likely in your case. If this does happen I would call your surgeon immediately so they can release the pressure. Once the vision is gone for a period of time from this cause it is very difficult to bring it back

Hope this helps.

Blurry vision after a blepharoplasty is usually related to swelling of the sclera (whites of the eyes) and eyeball, which distorts the cornea. It is important to make sure that there is no corneal abrasion or infection present. In effort to prevent infection, antibiotic eye drops are prescribed for the postoperative phase, and Lacri-Lube ophthalmic ointment is prescribed for nighttime use.

Blurry vision 3 weeks after eye surgery is not very common. This can be due to irritation of your cornea or even from overuse of lubricating ointment during the day. The lubricating ointment should be used at night and eye drops should be used during the day if the eyes feel dry. Seeing an ophthalmologist is a good idea to look into the possible problem.