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

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.

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