An eyelid that has been damaged may not adequately protect and lubricate the eye. Injuries and scars can cause retraction in which the lower eyelid is pulled downward. Depending on the degree of scarring or retraction, symptoms such as tearing, blurry vision, and chronic eye irritation may occur. These symptoms can exacerbate the frustration that already exists due to the cosmetic effects of eyelid scarring.
What Is Eyelid Scarring?
Eyelid scars may result from trauma or facial or eyelid surgery. This can affect the normal position of the eyelid to such an extent that mobility is interrupted. Sometimes, eyelid scarring makes it impossible to fully close the eye, leading to chronic dryness and irritation. When the lower eyelid is scarred, the eye may show more white than the other eye.
What Is Eyelid Retraction?
Eyelid retraction is usually diagnosed when the upper eyelid sits in an abnormally high position compared to the other eye. Likewise, retraction could affect the lower eyelid when the position is unusually low. What’s normal? The upper eyelid should rest just above the iris, the colored part of the eye. The lower eyelid should rest just below it.
An eyelid may become retracted due to trauma or poor surgical healing. Retraction is also a common side effect of thyroid eye disease, or Grave’s disease.
Correcting Eyelid Scarring or Retraction
Treatment for eyelid scarring or retraction may first focus on controlling symptoms like chronic dryness and excessive tearing. This may be achieved with bandages, ointment or eye drops, or other comfort modalities. Strategies such as these may control symptoms but they do not correct the problem. This is only possible with surgery.
- Upper eyelid correction may involve adjustments to the levator muscle. This muscle controls where the eyelid sits over the eyeball.
- Lower eyelid correction may require more extensive repair. When possible, canthoplasty is performed to tighten the skin and tendons under the eye. In some cases, tissue grafting or a mid-face lift may also be necessary.
- Eyelid retraction that is related to Grave’s disease may benefit from orbital decompression, in which space is created in the eye socket for the eyeballs to sit back in a normal position.