There are many unwanted changes associated with aging. One common change seen in an ophthalmology office is extra skin overhanging a person’s upper eye lids. This entity is known as dermatochalasis. It occurs nearly universally as people age but is more common in certain ethnic groups such as northern Europeans. When the skin sags enough, it will interfere with vision especially in the superior field of vision. Additionally, excessive skin can cause eye fatigue as the muscles of the upper lids and eyebrows attempt to pull the extra skin out of the line of vision.
There is a solution to this frequent problem. It is a surgical procedure called an upper lid blepharoplasty. A blepharoplasty is probably second in frequency only to cataract surgery in an aging population. It is quite common and is immensely helpful to improve vision. Patients should consider an upper lid blepharoplasty if they can pull up their upper lids and notice an improvement in vision.
In the process of an upper lid blepharoplasty evaluation, a visual field with a person’s eyelid taped up is necessary. This is to confirm that surgery is functional in nature and not just cosmetic. The taped visual field and an external photo with necessarily be submitted to insurance for coverage approval. At this point, the surgery can be scheduled in an outpatient setting. Usually, a preoperative physical is needed and consents for surgery obtained. The procedure to remove the excessive skin and additional tissue is done under intravenous sedation and takes about 40 minutes.
It is important to have ice packs available for the first 48 hours as the upper and lower lids will both swell and bruise. The bruising lasts for several weeks but progressively improves. Sutures are used to close the incision and these are easily removed in the office at one week. There are very few limitations after the procedure other than avoiding swimming and trauma to the incision. The procedure is well tolerated and very helpful to improve superior peripheral vision.