Do I have Dry Eyes From Revision Surgery to Fix Scleral Show?

[Jack]

I would be extremely grateful to communicate with someone who has the following symptoms and eye history that I do.

The outer corner of my right eye suffers from several different sensations. The most common is as if an eyelash poking me. And, I often find one at the doc office that is poking me. But pulling it out does not make anything better. Other sensations including stinging at times, the feeling that a rough patch of inner eyelid is rubbing on my eye, and a general weakness in the surrounding area,

I have seen several occuloplastic surgeons about this, and they all say if I bring up my lower eyelid some more this will go away, because, despite my previous revision surgeries, my eye is still too "exposed". They recommend surgery.

What I am not hearing from any doctor is precisely why I have these strange sensations. It seems to me, "intuitively" that the upper lid curls in and out at will, and when that happens, it causes various irritating sensations in my outer corner. Or, if not that, there is something embedded in that area, that is physically causing the sensations.

Can anybody relate to this? Many thanks.

[farmgirl]

What kind of surgeries have you had in the past to fix the scleral show? and what kind of procedure are they recommending in the future?

[Jack]

Hi farmgirl thanks for responding. Apologies for late reply I have been traveling. I have had two surgeries where they made an incision in the outer corner of my eye and pulled my tarsus tighter, and released the retractors. Did not put in a graft or spacer of any sort. The scleral show is fixed ok enough.

The surgery recommended is basically to put in a spacer graft and pull my eyelid up even more, as they say that it is the tautness of my lower lid plus too much eye exposure that is causing my discomfort. These would be two of Los Angeles's most well known Occuloplastic surgeons. Each one has a different plan on how to accomplish that.

Any input is appreciated, thanks.

[farmgirl]

The reason I ask Jack is that, no I cannot speak to the strange sensations that you are getting in the corner of your eye as I have never experienced that, but rather I have had a couple of surgeries on my eyes 1 of which helped with the dryness and two that did not. Are your eyes actually dry or do you just get the strange sensations and do they feel that the sensations are related to dry eye?

Second question is, are your eyelids actually too taut and if so how will a spacer graft help? Is the graft to be placed along the margin of the lower lid?...F/G

[Jack]

They say my eyelids are too taut, but I don't physically feel them as being too taut. I basically would be taking their word for it. I don't know if my eyes are dry, because I do have some of the symptoms of dry eye, but using eye drops do not help at all, and they are not dry as in "not wet". But then on the other hand, from what I read, eyes are not necessarily actually dry to be suffering from "dry eye".

The spacer would be along the margin of the lower lid, yes, as you say. Thoughts? (and thanks!)

[farmgirl]

I do in fact suffer from dry eye, sjogren's to be exact. I recently had surgery which sounds like what you describe, where a graft from my ear was placed along the lower lid to support the lid, eliminate sclera show and I believe give me a firmer blink. I only had one eye done but that eye is now about 80% better than the non surgeried one. I will have it done later this year. I only did one at a time because I did not want to risk surgery if it was not going to help. The previous surgery was called a canthopexy and did not help. It sounds like you maybe had a canthoplasty done which is a bit more invasive.

Whatever you have done I would recommend only doing one eye at a time possible the worst one that is giving you the strange sensations. Good luck keep me posted...F/G

[Jack]

Hi FG, thanks again for responding. My problem is only in one eye, the right one. I am curious about the graft that was put in your eye lid - did it make it feel heavier, or anything like that? Do you have any side effects from it?

One doctor I saw wanted to use cartilage from the roof of my mouth (common) and the other wanted to use skin from my upper eye. Do you know if your doctor pulled the tarus and tightened it up, sewing the end to a new location?

Many thanks.......Jack

[farmgirl]

Hi Jack: Yes he did the 'tighten the tarus' surgery first I think that is called the canthopexy. A different Dr did the graft as the first was not an ocular plastic surgeon so did not have the skills to do the more complex surgery.

To answer your question no, the graft does not affect the feel of my eye, I do not notice it. You can use cartilage from the roof of the mouth but for some reason my surgeon prefers to use ear cartilage. I think from the roof of the mouth might be better though at least that is what I have read. The recovery process I understand is more difficult for the patient though as the mouth is quite sore for a bit of time. Right now I have a bit of a lump where the end of the graft sits which he says he can get rid of but honestly I would take the lump over no graft because the eye feels so much better.

[jess]

Greetings to both I hope you are able to respond to these posts.
I have dry eye and it has been a problem for years. Also, about 15 years ago, i started to have trouble closing my eyes all the way at night. I began with ointment, now I have to tape them at night. I saw an ocular plastic surgeon and he has recommended tightening my lower lids with a graft, both, one at a time, and that is due to my dry eye. He said it would also improve the sclera show but I do not believe that is too bad.
I am wondering, if you could do the lower lid retraction surgery over, would you? Do you feel it helped? Was it worth it, or did it cause more problems? I don't want to do anything that might cause more problems.
thanks to you both I hope you will get this. I am trying to stay within current posts.
Gina

[Jack]

Jess, sorry for the months long delay. I would not do the revision surgery again, no way. The fristration I feel from what I think was a complcation from that far outweighs the cosmetic benefit. yet, I have read of a lot of happy revisionist surgery patients. I think what happened to me is quite rare.

Perhaps I would chose to do a differnt type of revision surgery though.

[farmgirl]

Have you tried a course of steroids to reduce inflammation and see if that is the problem?

[TARYN]

I had the lower eyelid surgery with a hard palate graft and I am happy with both the cosmetic and function results.

[Jack]

Have you tried a course of steroids to reduce inflammation and see if that is the problem?

I have tried some steroid drops, that seem to help, a little, sometimes. But I also read a lot of side effects from them, like cataracts, and also steroids weaken muscle tissue, according to things I have read. Some doctors think that is more of a problem than other doctors.