Eyelid retraction surgery is performed to correct abnormal eyelid positioning caused by tissue tightness or fibrosis that prevents the eyelid from fully closing or resting in its normal position. Eyelid retraction may cause the upper eyelid to elevate excessively or the lower eyelid to be pulled downward, resulting in ocular exposure, compromised eye health, and aesthetic concerns. The procedure restores proper eyelid function and positioning by releasing or lengthening the affected eyelid tissues.
Eyelid retraction refers to an abnormal elevation or downward displacement of the upper or lower eyelid, resulting in excessive exposure of the eyeball. It is most commonly seen in the upper eyelid, giving the appearance of a "wide-open" stare or causing the sclera (the white of the eye) to become visible above or below the cornea—known as superior or inferior scleral show. Beyond its cosmetic impact, eyelid retraction can lead to significant ocular discomfort, including dryness, foreign-body sensation, tearing, light sensitivity, exposure keratitis, and in severe cases, visual impairment.
The most common cause. Inflammation and fibrosis of the extraocular muscles—particularly the superior rectus and levator muscles—or orbital fat can lead to excessive contraction of the levator muscle or forward displacement of the eyeball, resulting in eyelid retraction.
Procedures such as double eyelid surgery or ptosis correction may cause eyelid retraction if overcorrected or if scar contracture develops.
Injury to the eyelid tissues may result in scar contracture and subsequent eyelid retraction.
Partial oculomotor nerve palsy may cause abnormal eyelid elevation.
Tumors involving the eyelid or orbit may alter eyelid position.
A small number of infants may be born with eyelid retraction.
Long-term use of certain medications, such as adrenergic eye drops, may contribute to eyelid retraction.
Surgery is the primary treatment for eyelid retraction, aiming to restore the eyelid to a normal or near-normal position, protect the ocular surface, and improve cosmetic appearance. A variety of surgical techniques may be used, and the optimal approach is selected based on the severity of the retraction, its underlying cause, and the patient's specific condition.
To weaken the upward pulling force of the levator muscle or Müller's muscle by recessing or partially cutting the muscle, thereby lowering the upper eyelid.
The procedure may be performed through a conjunctival approach or a skin incision.
Suitable for mild to moderate upper eyelid retraction, particularly in cases caused by thyroid eye disease.
To elevate and support the lower eyelid by placing a graft between the lower tarsal plate and the inferior orbital rim.
The procedure is performed through a skin incision.
Suitable for moderate to severe lower eyelid retraction.
To release or recess the lower eyelid retractors, thereby reducing the downward pulling force and allowing the lower eyelid to elevate to a more natural position.
The procedure can be performed through a transconjunctival or transcutaneous incision.
Suitable for patients with mild to moderate lower eyelid retraction.
To place a graft between the lower tarsus and the inferior orbital rim, providing structural support and elevating the lower eyelid.
Performed through a transcutaneous incision.
Suitable for moderate to severe lower eyelid retraction.
When lower eyelid laxity or ectropion is present, the procedure tightens the lateral canthal tendon to elevate and stabilize the lower eyelid.
Performed through an incision at the lateral canthus (outer corner of the eye).
One Week Before Surgery:
・Discontinue anticoagulant medications (such as aspirin). Please confirm with your prescribing physician whether temporary discontinuation is appropriate.
・Stop taking all nutritional supplements (such as fish oil, ginkgo, ginseng, and vitamin E).
・Avoid smoking and alcohol from one week before surgery until one month after the procedure.
On the Day of Surgery:
・Please arrive with a clean face and no makeup; remove any eyelash extensions.
・Do not wear any accessories or metal items. If you have piercings, please remove them in advance.
・If you are nearsighted, you may wear contact lenses to the clinic, but they must be removed before surgery. Please bring a storage case, eyeglasses, or sunglasses for use afterward.
・Please do not drive or ride a motorcycle yourself after the procedure.
・Local anesthesia does not require fasting, and you may eat and drink as usual.
・General anesthesia requires fasting for approximately 8 hours. Please avoid all food and drinks, including water and chewing gum.
・Cold and Warm Compresses: Apply cold compresses during the first 72 hours after surgery to help reduce swelling and bruising, and keep your head elevated as much as possible. Warm compresses may be started after 72 hours to promote circulation and healing.
・Wound Care and Dressing Changes: Keep the incision area clean and dry after returning home, and change dressings as instructed. If skin sutures are present, they are typically removed around 6–10 days postoperatively, depending on wound condition.
・How to Change Dressings: Clean the wound twice daily using sterile cotton swabs dipped in normal saline, dry the area, and then apply the prescribed ointment. When performing cold or warm compresses, place a piece of gauze over the wound to reduce the risk of infection.
・Medication and Eye Hygiene: Use the prescribed eye drops or ointment as directed to prevent infection and support healing.
・Eye Use and Daily Habits: Avoid prolonged use of mobile phones, computers, or looking down for extended periods. Allow your eyes sufficient rest to facilitate recovery.
・Diet and Medications:
- You may take the prescribed pain relievers as needed to ease postoperative discomfort.
- Avoid irritants such as smoking, alcohol, tea, coffee, spicy foods, and dietary supplements (including vitamin E, lingzhi, and traditional herbal medicine).
- A light diet is recommended, along with adequate hydration and increased intake of protein and vitamin C to support wound healing.
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2F, No. 263, Sec. 1, Dunhua S. Road,Da'an District, Taipei City 106, Taiwan
Our clinic operates by appointment only.