Eyelid Retraction Repair
Lower eyelid retraction is a condition in which the lower eyelid is too low. This can lead to symptoms of tearing and discomfort. Common causes of lower eyelid retraction include thyroid eye disease and previous eyelid surgery such as transcutaneous (through the skin) lower blepharoplasty. This patient had lower eyelid retraction that was corrected by releasing the lower eyelid retractors, a midface lift, placement of a posterior spacer graft, canthoplasty, and a Frost suture tarsorrhaphy. After surgery, the lower eyelid is returned to a normal position.
Eyelid retraction is a condition in which the eyelid is against the eyeball but rests too low (lower eyelid) or too high (upper eyelid), often leaving the eye exposed and dry. Untreated, this can lead to chronic tearing, eye irritation, redness, pain, crusting, discharge, damage to the cornea, and blurry vision.
Causes include age-related loosening of tissues, sun damaged skin, skin cancer, thyroid eye disease, and previous surgery (i.e. transcutaneous lower blepharoplasty or other eyelid or orbital surgery that has resulted in scarring of the orbital septum). Eyelid retraction may also occur as a result of facial nerve palsy (due to Bell’s palsy, stroke or other neurological conditions).
Eyelid retraction can be repaired surgically. Age-related eyelid retraction of the lower lid is typically repaired by tightening and/or repositioning the lower eyelid. Regardless of the cause of lower eyelid retraction, sometimes additional techniques are necessary such as releasing the eyelid retractors, placement of a spacer graft (i.e. acellular dermal matrix, dermis-fat graft, hard palate graft), and a midface lift. For upper lid retraction, depending on the severity, the eyelid can be lowered through either a skin incision or an incision on the inside of the eyelid. Additionally, some patients may be candidates for non surgical treatment of upper and lower eyelid retraction using filler injections. Dr. Mettu will determine the best approach for eyelid retraction repair after a careful examination. The goal of eyelid retraction repair is to obtain a natural eyelid position that helps improve symptoms.