Can droopy lower eyelids be the cause of DES?

[Ariel]

I am noticing the artificial tears I use fall out of my eye as soon as they come in contact with it. My lower eyelids are a bit droopy so I show about 2 millimeters of white below my pupils.

I had been told that I needed surgery to pull up my lower eyelid but this was only proposed to me as a cosmetic procedure sometime before I developed DES. I am now wondering if my droopy eyelid could be the cause of my dry eye. I have blepharitis so I have assumed to be the the sole cause of it.

[Rebecca Petris]

I am now wondering if my droopy eyelid could be the cause of my dry eye. I have blepharitis so I have assumed to be the the sole cause of it.

Yes - it can be (see my other post in this thread). But surgically fixing it can also cause or exacerbate dry eye.

Most people with dry eye, I believe, are 'multi-factorial' in some way or another.

[regina]

hey Rebecca...

I remember a gal on here that had surgery to fix her too big of eyes...she had a pic of before and after...looked great. She said it fixed her moisture problem by reducing the area to keep wet...do you remember her ? they did a nip and tuck on the corner of her eyes...I remember how fascinating this was that they can make it look so good!

Yes - it can be (see my other post in this thread). But surgically fixing it can also cause or exacerbate dry eye.

Most people with dry eye, I believe, are 'multi-factorial' in some way or another.

[Ariel]

I think that having a droopy lower eyelid in my case can be causing or contributing to my tears draining out of my eyes when they should remain on them.

A blepharoplasty can be performed to expose or to cover part of the epithelium. If you lift a droopy upper eyelid you will expose the epithelium more than it is but if you pull up a droopy lower eyelid you will be doing the opposite.

In my case lifting my lower eyelids will cover the 2 mm of white below the pupil that is now exposed, presumably alleviating the DE symptoms, but most importantly it would eliminate the unwanted outlet the droopy lower eyelid is providing for my tears to drain out of the epithelium when they shouldn't be doing it, which could perhaps be the most important cause of my DE condition.

I would think that if my tears are draining out of my eye when they should be staying in it, that in itself can cause DE, but perhaps there is a second reason why the artificial tears I use do not stay on my eyes which can be that the musin layer has large dry spots that keep them from adhering to the eye surface.

[TARYN]

ariel

Ariel,
I had my lower lid lifted with a canthoplasty a an alloderm spacer to give the lower lid the support it needed. It helped cosmetically because it made my lids
a more attractive shape, but because I had meibomian gland dysfunction, it didn't help the dryness. If the shape of your lids is the only problem, then it might help keep the tears on your eyes longer.

[2dry2cry]

I have "prominent" eyes and am scheduled for lower lid retraction surgery with an oculoplastic sugeon. I think most of the surgery is done below the lid and not actually on the lid itself. I'm not sure, but I'm hoping it will help a little and not exacerbate the dryness

[Lucy]

Do you have thyroid or autoimmune (Sjogrens) problems? If so, you might want to get that under control before eye surgery. Just checking, as I have both.

[2dry2cry]

Not sure who you're asking, but I've been tested for everything and they can't seem to find any thing systemically that is causing my dry eyes. I seems like Sjogren's, but all the tests are negative. Is there any treatment for Sjogren's, or is it just a matter of managing symptoms?