Eyelid Retraction

Eyelid retraction is when the upper eyelid is pulled up or the lower eyelid is pulled or pushed down. Most retraction, though, involves the lower rather the upper eyelid. Some patients describe the eyes “bulging” or “buggy.” Retraction increases the cornea exposure to air and can lead to dryness, eye irritation and/or pain, redness, blurry vision and tearing. Eyelid retraction is caused by various conditions (i.e. aging, chronic inflammation, scarring, prior surgery, eyelid mass, or Graves disease). Eyelid retraction can be repaired by a number of surgeries, depending on the associated condition and severity of the retraction. For retraction due to laxity of the eyelid from aging, the eyelid may be tightened and pulled to the orbital rim with a suture through a small incision at the lateral canthus (the outside corner of the eye). If there is also skin shortening from chronic inflammation, scarring, eyelid mass, etc., a skin graft will be placed to lengthen the eyelid vertically. In cases of severe retraction, an implant may be placed in the eyelid to further push the eyelid in the desired direction. This is typically done in conjunction with the other described procedures. In mild lower eyelid retraction, dermal filler may be used to lift the eyelid up. This is typically done to restore ideal eyelid contour and thus improve aesthetic rather than function.