The periocular region of our face (area immediately surrounding the eye, encompassing the eyelids, eyebrows, eyelashes, and surrounding skin) is the most fascinating and interesting element that others usually first notice in us (1). The first signs of aging of the face typically occur in this area and eyelid sagging is a natural part of aging. But in some people, drooping eyelids occur much earlier due to a combination of several factors such as loss of skin elasticity, weakened eye muscles, fat redistribution, genetic preponderance and some medical conditions (2).
These afflicted individuals experience chronic eye strain and protracted blurry vision, persistent headaches, and a constant, heavy-eyed feeling, get little relief from ergonomic adjustments, screen filters, and lifestyle tweaks. It is in this context that blepharoplasty, a routine cosmetic eyelid surgery, can actually become a functional solution for chronic eye strain.
What Is Blepharoplasty?
Blepharoplasty is derived from the Greek words meaning “eyelid” (blepharon) and “to mold” (plastós) (3). It is a surgical intervention that involves removing or repositioning excess skin, fat, and sometimes muscle in the eyelids to restore both function and aesthetics. Blepharoplasty is undertaken for both cosmetic and/or functional reasons and in the last 10 years has been one of the top five most commonly performed surgical procedures worldwide (4). Sagging eyelid tissue (medically referred to as dermatochalasis) from either aging or other etiological factors interferes with vision. In fact, eyelid skin that droops low enough to obscure the upper or peripheral vision can lead to eye strain and decreased visual clarity and under such circumstances, blepharoplasty can become medically necessary.
When Is It Medically Appropriate?
You may be a candidate for functional blepharoplasty if you meet one or more of the following criteria:
- You suffer from chronic eye strain or tension headaches, especially after prolonged screen use or reading. This is caused by constant use of the eyebrow muscles in holding up the heavy drooping eyelids.
- Your upper eyelid skin obstructs/interferes with your field of vision, especially when looking up or reading.
- Your eyes always feel tired, heavy, or appear smaller, and routine daily activities like driving or reading start to feel more taxing.
- You attempt to compensate for the restricted field of vision by raising your eyebrows or tilting your head. These actions also lead to developing forehead creases and tension headaches from overactive exhausted eyebrow muscles.
- Significant obstruction of peripheral vision is confirmed via visual field testing. If documented by an ophthalmologist, you can be eligible for insurance coverage.
What are the Benefits of Functional Blepharoplasty
Improved Visual Clarity
Sagging eyelids interfere with the field of vision and removing the excess upper eyelid skin tissue helps unobstructed vision in the upper and peripheral fields. Prior to the procedure, patients often describe their restricted vision as “looking through a keyhole” which is rectified post-surgery.
Reduced Eye Strain and Headaches
Constant and continuous use of the eyebrow muscles to keep sagging eyelids open leads to muscle fatigue and discomfort. This result is both chronic eyestrain, discomfort and tension headaches. After surgery, many patients report dramatic relief with fewer headaches, not needing to raise their eyebrows, and improved reading ability or screen tasks.
Enhanced Function with Cosmetic Uplift
Blepharoplasty is also a cosmetic procedure and the majority of cases are performed for aesthetic reasons (4). Along with achieving the primary goal of improved vision, blepharoplasty also revitalizes appearance, making you look more rested and refreshed.
Often Insurance-Covered
When recommended by an ophthalmologist as an essential intervention required for restoring vision and improving eyelid function, blepharoplasty can be considered medically necessary and may be covered by insurance. This is unlike purely cosmetic reasons.
Improved Quality of Life
The functional and cosmetic results from blepharoplasty can certainly lead to an improved quality of life. Patients frequently report a new sense of ease in daily living with reading, driving, screen use and focusing become more comfortable and strain-free.
Choosing the Right Path: A Guide
As with any major medical procedure, to decide whether blepharoplasty is the best course of action for your chronic eye strain, consider the following:
Consult an Eye Care Professional
A visual field test to pinpoint whether your visual field is restricted is a good starting point. This exercise should be undertaken by an ophthalmologist or oculoplastic surgeon who will also examine the extent of sagging in the eyelids to determine if blepharoplasty can be recommended or not.
The Type of Procedure
- Upper eyelid blepharoplasty removes excess skin that blocks vision.
- Ptosis repair (a medical condition where the upper eyelid droops, potentially blocking vision) may also be needed if upper eyelid muscle weakness is the issue.
- Sometimes a combination procedure (blepharoplasty + ptosis repair) might be required to have the best possible outcome.
Understand the Process
Blepharoplasty is typically an outpatient procedure most commonly performed under local anesthesia, with tiny incisions hidden in natural eyelid folds. Recovery time spans about 10– 14 days, with initial swelling and light bruising from the procedure.
Evaluate the Risks and Outcomes
Possible side effects include temporary blurry vision, dry eyes, or bruising. Rare complications such as infections do exist but are infrequent when performed by an experienced surgeon. Hence the choice of provider is an important decision.
Cosmetic vs. Functional Goals
Since blepharoplasty is performed for both cosmetic and functional reasons it is imperative to make informed decisions. Also, insurance coverage cannot be availed for cosmetic interventions.
When Blepharoplasty Might Not Help
As with all medical procedures, blepharoplasty also may not be helpful for certain situations such as when:
- Eye strain that stems from vision prescription issues (e.g. Glasses), dry eyes, or ergonomic factors (bad posture, prolonged screen usage etc.).
- When vision obstruction is not from sagging eyelids.
- When poor or blurry vision rather than vision obstruction is the cause.
Consult with Dr. Raymond Douglas Today!
Chronic eye strain has become an unfortunate and common consequence of using modern technology and blue-light screens. Sometimes the problem lies at the level of obstruction from sagging or drooping eyelids. In this scenario, blepharoplasty, if medically greenlit by an ophthalmologist or ocular surgeon, can deliver life-changing relief leading to clearer vision, reduced eye strain, fewer headaches, and significant improvement in quality of life. It also comes with the added bonus of a more refreshed youthful appearance!
If drooping eyelids are causing you chronic eye strain, blepharoplasty might be the relief you’ve been looking for. Reach out to Dr. Raymond Douglas today to find out how this procedure can help improve your vision and overall quality of life.
References
- Miotti G, Zeppieri M, Pederzani G, Salati C, Parodi PC. Modern blepharoplasty: From bench to bedside. World J Clin Cases. 2023;11(8):1719-29. doi: 10.12998/wjcc.v11.i8.1719. PubMed PMID: 36969996; PMCID: PMC10037276.
- Jacobs LC, Liu F, Bleyen I, Gunn DA, Hofman A, Klaver CC, Uitterlinden AG, Neumann HA, Bataille V, Spector TD, Kayser M, Nijsten T. Intrinsic and extrinsic risk factors for sagging eyelids. JAMA Dermatol. 2014;150(8):836-43. doi: 10.1001/jamadermatol.2014.27. PubMed PMID: 24869959.
- Bhattacharjee K, Misra DK, Deori N. Updates on upper eyelid blepharoplasty. Indian J Ophthalmol. 2017;65(7):551-8. doi: 10.4103/ijo.IJO_540_17. PubMed PMID: 28724810; PMCID: PMC5549405.
- Joshi K, Hohman MH, Seiger E. SMAS Plication Facelift. StatPearls. Treasure Island (FL)2025.
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