Note this case contains graphic images from surgery.
Chief Concern: This 28-year old has a history of childhood thyroid eye disease. She had orbital decompression at the Jules Stein Eye Institute as well as several other eyelid procedures. However, she has difficulty closing the eyelids.
Diagnosis: The patient had a profound benefit from her prior orbital surgery. However, she manifests poor projection of the inferior orbital rim. Consequently there is poor support for the lower eyelid and cheek. The lower eyelids hang below the curvature of the eyes. This prevents the eyelids from meeting upon lid closure.
The lateral canthus is then resuspended and the skin is closed (Figure 7). Because the eyelids are immobilized and patched closed for a week to permit healing, only one side is done at a time. The other side was done 10 days later.