What Causes Blurry Vision After Blepharoplasty?

No complications occured during the procedure and I could see clearly for a week after the surgery. Now, three weeks after, my vision is extremely blurred. According to two physicians who examined me, there was no damage or infection present, only that my eyes are dry. I have been using the eyedrops and eyegel prescribed by the doctor, but my vision is still blurry. What could be causing it?

Doctor Answers 17

Blurring after surgery

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The causes of blurring after surgery include:

  1. Swelling if the eyelids that causes a distortion of the cornea - this should resolve on its own.
  2. Dryness as a result of swelling of the eyelids. The lids do not distribute the tear film evenly across your eye , thereby distorting your vision. You may see additional tearing but still feel dry. This should, also resolve as the swelling resolves.
  3. Dryness as a result of eyelids that do not close normally. This can be the result of post-operative swelling or more ominously the result of too much eyelid tissue removed during the surgical procedure. This last problem is a problem.
  4. Too much eye lubrication can also make you blurry.

As all the other doctors who commented here, go see an Opthalmologist ASAP. Ask about all of the issues I described above.Best of Luck. Robert M. Freund, MD

New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

You need to see an ophthalmologist soon

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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

Vision change after blepharoplasty

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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.

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon

Several potential problems

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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.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Gel only at night

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Hopefully, the two physicians that examined you were ophthalmologists. If you are using the gel during the day, this could account for your blurred vision, especially if there is a relationship between when you started the gel and the blurriness. Use the drops 4-5 times a day and the gel only at night. Follow up with your surgeon and let him/her know your complaints and good luck!

You need to see an Ophthalmologist.

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Blurring of your vision immediately after eyelid surgery is normal. The combination of ointment after surgery and slight changes to the cornea from the numbing medication can have a blurring effect. I consult all my patients not to worry about their prescription in the first 2 weeks, as it will come back to normal. This is just a slight change in vision, not significant blurring.

After 3 weeks, you need to be evaluated by a ophthalmologist or specialist in corneal evaluation.
You may have an exposure issue causing drying or abrasion of the cornea. Just using drops may not be sufficient. Even if your surgeon was an Ophthalmic Surgeon, go see someone else. You need to also have them examine the back of your eye, the retina. If there was pressure on the Optic Nerve after surgery, this could alter your vision.

Many of these issues do resolve with time, but need to be treated appropriately.

Blurry vision after blepharoplasty usually due to ointment

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By far the most common cause of blurry vision after


is the use of ointments to keep the eye moist. Since you had ointments precribed for dry eye this is most likely.

Occaisionally, tightening of the lower eyelid by a canthopexy or lower blepharoplasty with external incision and lateral orbicularis muscle pexy tightens the lid sufficiently to change the shape of the eyeball. This can alter your refractive index or ability to focus. if this occurs it usually resolves in 6 weeks or so. Sometimes a change in eye glass prescription is required.

Rarely the extra occular muscles can be injured which interferes with eye movement-but this would cause double vision not blurred vision.

Flourescein dye exam of your cornea is also a good idea and i assume this has been done as part of the two eye exams that you have had.

Late blurred vision will require further exam

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Initially your vision was normal and then it blurred three weeks later. Addressing the dry eye problem with saline and gel may be part of the issue. I have used gel on patients in the past and it has caused blurring just from the gel. Obviously you have to address the dry eye but you may want to discuss the treatment regimen with your surgeon and/or an opthalmologist. I suspect this will help your blurring significantly. All the best.

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon

Blurry vision after a blepharoplasty

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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.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Many possible causes

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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.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.