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Lower eyelid retraction repair - what causes it and how to treat it!


Eyelid retraction is a malpositioning of the eyelid that can affect the lower eyelid, the upper eyelid, or both together. It occurs when the eyelid pulls away from the eyeball.



Causes of eyelid retraction


  • Common causes of retraction of the eyelid include:

  • Trauma

  • Eyelid surgery complications

  • Thyroid eye disease or Graves disease

  • Tumours

  • Parkinson's disease

  • Facial nerve palsy

  • Herpes zoster infections

  • Prolonged contact lens use

  • Radiation therapy


What are the symptoms of eyelid retraction?


As the eyelid pulls away from the eyeball in eyelid retraction more of the eye is exposed. Retraction symptoms can include the following:

  • Dryness of the eyes

  • Irritation

  • Pain,

  • Redness

  • Swelling of the conjunctiva (the layer overlying the white of the eye)

  • A wide eyed appearance


Treatment of eyelid retraction


Conservative treatments for retraction will usually be the first to be offered and include massage and the use of artificial tears and ointments to lubricate the eye. This should provide some relief of the symptoms if the patient is comfortable with the appearance of their eyes. It may avoid surgery depending on the location and severity of retraction.


A surgical procedure procedure may be required. Grafting techniques might be needed to reposition the eyelid to a more natural shape these include the use of hard palate graphs, free tarsal grafts, and spacer graphs. For minimal retraction of two millimetres or less an eyelid tightening procedure might be all that is required.


What causes lower eyelid retraction?


Lower eyelid retraction most frequently occurs to thyroid eye disease affecting the eye and is associated with fibrosis of the capsular palpebral fascia and inflammation which can result in tissue loss and a cicatricial change of the lower eyelid.


Can eyelid retraction go away?


The amount of retraction can be variable and vary from week to week. In some patients retraction of the eyelid will resolve with time. In others it may not and can increase and will require surgery in order for it to be resolved.


How much is lower eyelid retraction surgery?


The average cost of lower eyelid retraction current surgery is typically £3000 pounds upwards and this depends on whether a general anaesthetic is required, the type of spacer graft used if necessary, and whether one or both eyes are being treated. If you have private medical insurance treatment for lower eyelid retraction may be covered depending on the cause and your policy.


What can I expect after eyelid retraction surgery?


You tend to be able to go home the same day as your surgery after eyelid retraction repair. There is usually minimal pain with slight discomfort and an eye patch placed over the eye for a day or two. Heavy Lifting lifting should be avoided for two weeks.


What causes lower eyelid retraction after blepharoplasty?


Following blepharoplasty, there may be fibroblasts and healing that results intention to the lower lid causing lower eyelid retraction. In few cases, too much skin is removed from the lower eyelid resulting in lower eyelid retraction.


Can lower eyelid retraction be treated without surgery?


In minimal cases of two millimetres or less, massage to the upper lower lid upwards for a prolonged period of two months or more may help improve the laxity of the skin and treat lower eyelid retraction in some cases, filler with modulating agents to treat scar can also be used to avoid surgery, but may require more than one session. Severe cases do require surgery to correct the eyelid position.

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