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What Causes Blurred Vision After Blepharoplasty?

Posted on Thu, 28 Sep 2017

Question: Last Wednesday I had a blepharoplasty, (upper lids only) and was given injections of Lidocaine and epinephrine to numb the area. Since then, my vision has been blurry and I saw an ophthalmologist today who noted a significant change in my vision compared to what my eyeglasses (prescribed only this past February) indicate as my prescription. The ophthalmologist insisted the vision change was likely due to elevated blood sugar. I then had an Accucheck and A1c done at my family doctor, both indicate NO problem with blood sugar and were within normal limits. So I'm assuming either the lidocaine or the epinephrine caused some damage to my eyesight...since it migrated to my cheeks the day of the surgery is there any reason to think that fluid couldn't have migrated to the inside of my eyes?

Answered by Dr. Lekshmi Rita Venugopal (2 hours later)

Brief Answer:
Blurred vision following Blepharoplasty

Detailed Answer:
Hello,
Thank you for trusting HCM

Blurred vision following Blepharoplasty is very common. This is because of dry eyes, mild edema in the cornea and change in corneal curvature. Usually, this will subside in few days. If persistent, you will need a change in prescription glasses to accommodate the change in corneal curvature. Most cases of blurred vision (>94%) will go away in a year.
However, if you are diabetic I recommend getting evaluated by an ophthalmologist to rule out diabetic retinopathy. It is recommended for diabetic patients to undergo evaluation by an ophthalmologist every 5 years.

Hope this answers your questions
Please address further questions here
Regards
Dr.Lekhmi

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Lekshmi Rita Venugopal (2 hours later)

I am not, nor have I ever been diabetic. You did not answer my question about the possibility that the lidocaine/epinephrine may have damaged my eye. I have been using drops since the procedure, so IF I had dry eyes, that should have resolved from the frequent use of eye drops. It has now been over a week since I had the procedure and the blurriness has not subsided. If blurriness is from edema to my cornea, how did that happen, given that the procedure was on tissue above my eye, not IN my eye? Why would my cornea be affected if the procedure did not touch my eye? I was awake during the entire procedure and my eye was never touched.

Answered by Dr. Lekshmi Rita Venugopal (12 minutes later)

Brief Answer:
Follow up answer

Detailed Answer:
Hello again,

The epinephrine and lidocaine will not cause blurry vision or damage your eye.
Corneal and scleral edema is due to the dry eyes and manipulation of surrounding tissue during surgery.Dry eyes is due to the fact that the process of closing eye lids will be affected during and immediate post operative period.The scleral and corneal edema will distort the curvature of cornea contributing to blurred vision.
Continue using eye drops. It will take few days for eyes to completely recover. The blurred vision will susbside in 1-2 weeks .
Sometimes manipulation of upper lid can cause persistent distortion of corneal curvature.This can lead to persistent blurred vision. If you do not notice any improvement in 1 week, follow up with your ophthalmologist for new prescription glasses.

Regards
Dr.Lekshmi

Above answer was peer-reviewed by : Dr. Kampana