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Is it possible that, as a consequence of blepharoplasty, the

lymph system in the conjunctiva...
Is it possible that, as a consequence of blepharoplasty, the lymph system in the conjunctiva could be blocked thus causing the lymph fluid to chronically collect in the eye resulting in conjunctival swelling?
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Answered in 1 hour by:
8/18/2011
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,652
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Verified
Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : In a uncomplicated blepharoplasty I do not think this would happen.
Dr. Rick : Would it be possible for you to upload a picture of your eye so that I could have a look at what is going on?
Customer:

I don't have the necessary photo. equip. to send a photo.

Dr. Rick :

How long ago was your blepharplasty? Also, was it lower and upper lids or just the top or just the bottom? Do you have any visual problems due to this swelling?

Customer:

Five months ago. Both upper and lower lids. Only some shadow in lateral vision.

Dr. Rick :

Ok. Let me make sure that I am understanding you correctly. When you say the lymph system is "blocked causing conjunctival swelling" do you mean that this is swelling that you can see on your eyeball when you look in the mirror? I ask this because I am confused by you mentioning that it is in your lateral vision.

Dr. Rick :

By in lateral vision do you mean that there is an actual shadow in your visual field when you look out of the affected eye? If this is true, we need to explore this fact in more detail.

Customer:

Yes, this is swelling I can see when I look in the mirror and it distorts my lower lid. The swelling causes an actual shacow in my lateral peripheral vision when I am looking straight ahead.

Dr. Rick :

Ok. Well. That is a lot of chemosis (swelling of the conjunctiva). I do not believe that your eyelid surgery would have caused this. It is possible that what you are seeing is orbital fat prolapse from your surgery, fat that "pooched" forward after the incision was closed.

Dr. Rick :

If this is the case it can easily be excised with a simple procedure under local anesthetic. Also, if the conjunctiva is that swollen (it is not orbital fat that is) then some of the conjunctiva can be removed in order to "solve" the swelling.

Dr. Rick :

This, of course, doesn't address the underlying cause of the chemosis (if it is not orbital fat) but it would serve to solve the problem.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

Just as a FYI, what has your surgeon had to say about all of this?

Customer:

What you say makes sense. My surgeon has not said much except to refer me to an ophthamologist. The two that I have seen so far seem stumped and the last one sent me to see another surgeon whom I will see next week. Since there is no infection or inflammation, I agree with your theory that there is a physical circumstance causing the chemosis. I am not quite sure why ice packs seem to be the only thing that reduces the swelling albeit temporarily. I must say, I am less than impressed with my surgeon's concern with regard to finding a solution to my problem.

Customer:

The chemosis is in exactly the same area of the eye which exhibited severe ecchymosis immediately after the surgery and lasting four weeks which the surgeon said was caused by the puncturing of a blood vessel during injection of local anesthetic.

Dr. Rick :

It is possible that the sub conjunctival hemorrhage has torn your conjunctiva away from the underlying layer (tenons capsule) and what you are experiencing now is called a conjunctival cyst that is forming in this "space" between the two tissue layers.

Dr. Rick :

If this is indeed the case it may have to be be drained and, possibly, excised. Sometimes light cautery can fuse the layers back together and get the "swelling" to go away.....but, worst case scenario, surgical excision usually works.

Dr. Rick :

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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,652
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Dr. Rick
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,652
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Experience: Ophthalmology since 1994 with Retina sub-specialty interest

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