Lidlift Kenneth D. Steinsapir, M.D.
Cosmetic, Facial & Eye Plastic Surgery

Since my eyelid surgery my eyes seem very dry and at night I don’t think I close my eyes. What can be done about this?

Dry eye commonly occurs in adults even without eyelid surgery. Typically, an existing dry eye condition returns to its presurgical status after about 6 weeks. It takes about this long because persistent swelling of the eyelid tissues after surgery can make dry eye symptoms worse. However, overaggressive surgery can produce long-term damage to the function of the eyelids worsening the dry eye symptoms. If too much upper eyelid skin was removed, the eyes may not full close at night causing dry spots to develop on the cornea accounting for the increase symptoms. Depending of the design of the blepharoplasty, the nerves that supply the muscle that helps close the eye can be damaged weakening the blink reflex. This means that during a blink there may not be sufficient speed or force to cause the upper and lower eyelids to mean during the blink. This is a problem because the eyelids move tears on the eye surface around. The net result is surface drying and symptoms. The first line approach to treating these issues is to increase the frequency of eye drops and, when indicated, ophthalmic ointment at bedtime. When needed, the tear drains in the eyelids can be closed temporarily with plugs to see if symptoms improve. When these measures fail, consideration may be given to reconstructive surgery. The nature of what is needed is very much directed by the severity of the symptoms and the degree of drying seen on the surface of the cornea. A range of options is available. However the key objective is to make the eyelids meet and to create sufficient force of eyelid closure to help spread the tears over the corneal surface.