Lowering an upper lid, or raising a lower one, that is pulled too far and shows more of the white of the eye.
What it is
Lid retraction is most often caused by thyroid eye disease, and sometimes follows other surgery. The lid is repositioned by releasing or lengthening the tissues that are pulling it.
The operation
For the upper lid, the muscles are released through the natural crease. For the lower lid, a graft is sometimes needed to lengthen it.
It takes about an hour, usually under local anaesthetic with sedation.
What it does not do
In thyroid eye disease the condition needs to be stable before the lid position is corrected. Your consultant will explain the order of treatment.
Who it can help
It may suit you if lowers a lid pulled too high, often in thyroid eye disease is what you notice most, and you are otherwise well.
- A staring appearance, with white showing above or below the iris
- Dryness and grittiness because the eye does not close fully
- A lid position that has been stable for several months
- Thyroid eye disease that is no longer changing
Where the eye is also pushed forward, orbital decompression usually comes first.
Recovery and risks
Everyone heals at their own pace. This is a typical course, and your consultant will tell you what to expect in your case.
The first two days
Swelling and bruising are at their most noticeable. Rest with your head raised and use cold compresses.
The first week
The lids feel tight or gritty. Stitches, where they are used, come out at about seven days.
Weeks two and three
Bruising fades. Many people are back at work and comfortable being seen.
Three to six months
Scars settle and soften. Your final review is around this time.
Possible risks
Every operation carries some risk. For eyelid retraction surgery these include:
- Dry or irritated eyes, usually temporary
- A small difference between the two sides
- A visible or thickened scar
- Infection or bleeding, which are uncommon
- Very rarely, a change in your vision
Your surgeon will go through the risks that apply to you, and give you written information to take home.
Insurance
Eyelid retraction surgery is sometimes covered when the problem affects your health or your vision. Surgery for appearance alone is not.
Check your cover with your insurer before your consultation, and your surgeon will supply what they need.
Questions patients ask
Will my eyes look even?
Your surgeon aims for a natural, even position, and adjusts the height during the operation. Small differences can remain.
Do I need to wait?
Usually yes. The lid position needs to be stable for several months first.
Is it covered?
Often yes, as part of the treatment of thyroid eye disease.
Will my eyes feel more comfortable?
Many people find the eye less dry once it closes properly, though drops are often still needed.