Anatomical factors leading to dry eyes symptoms after eyelid surgery.
Author: Bhagyashree Joshi
Base Hospital / Institution: Southampton General Hospital
ePoster presentation
Abstract ID: 24-236
Purpose
Incomplete eyelid closure commonly results in ocular surface evaporation of tear film and dry eyes symptoms. Other dysfunction of eyelid and eyelid components due to subtle post operative anatomical changes may be a diagnostic challenge but cause symptomatic eye discomfort.
Methods
The authors present a series of patients with eye discomfort symptoms or with signs of dry eyes, following elective eyelid surgery. The diagnosis, cause relation to anatomical changes, examination techniques and pre-operative evaluation, using a risk factor scoring system is discussed.
Results
A representative case series of five patients with symptoms of eye discomfort and signs of dry eyes following eyelid surgery (blepharoplasty, ptosis, ectropion and entropion correction and post reconstruction following skin cancer removal). The cases illustrate clinical diagnoses of evaporative tear loss, meibomian gland/ margin inversion, lagophthalmos, conjunctival chemosis and ‘Fish mouthing Syndrome’.
Conclusion
Eyelid surgery can result in eyelid shortening vertically or horizontally, changes to lid height, canthal positioning as well as changes to eyelid margin, meibomian glands and eyelashes.
Patients present with a variety of symptoms and signs describing dry eye and eye discomfort post eyelid surgery. Therefore, diagnosis is best derived with thorough clinical history taking to include skin conditions, systemic disease to include allergic disease, ocular history and drug therapy.
The authors propose guidance for static and dynamic evaluation of patient preoperatively for surgical planning and for assessing outcome, both before and after eyelid surgery. Examination, to include the ocular surface, eyelid margin, meibomian gland, eyelashes and position, orbicularis tone, evaluation of eyelid opening, closure blink and Bells’ phenomenon is important. The use of slit lamp microscope to help look for subtle changes to the eyelid and its’ components and, ocular surface is recommended.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Harinderjeet | Sandhu | Southampton General Hospital |
| Varajini | Joganathan | Southampton General Hospital |
