This patient wished to have eyelid surgery. He noted puffiness of the lower eyelids that was worse in the mornings and had been present for many years. He also felt that his lids were droopy and appeared to make him look older. He didn’t think he had dry eyes but used tears and felt his eyes were scratchy.
On examining the patient, there was a prominence of the lower eyelids. There was also lid laxity where the outer part of the lower lid seemed to hang more than the inner part of the lower lid. This resulted in giving the appearance of age and also gave too much “show” of the white part of the eye on the outside.
The patient was very gratified with the results of his surgery where fat was removed from inside the lower eyelid. The lid itself was also lifted to give better support and position for the lower eyelid itself.
The patient reported several months later that the itchiness and irritation of his eyes had significantly lessened.
As we age, tear quantity and quality can decrease which can result in dry eyes. Dry eyes can appear red and irritated and can itch and burn. Dry eyes can also lessen our ability to tolerate windy environments and also sunny ones. In addition to decreased tear production, lower eyelid laxity can also cause dry eyes. Loose lids can come away from the surface of the eye, resulting in loss of lubrication that tears provide. When cosmetic surgery is performed, an assessment for dry eyes is made and treatment is directed not only at making the eyelids look better but also to give better lid support for the purpose of decreasing dry eyes.
