Blepharoplasty complications

Blepharoplasty complications
SYMPTOMS Symptoms vary depending on complication: Undercorrection - superior visual field abnormality | Overcorrection - ocular surface dryness/discomfort | Infection - pain | Bleeding - pain | Scarring - no/minimal symptoms | Retrobulbar hemorrhage - pain
SIGNS Signs vary depending on complication: Undercorrection - superior visual field defect | Overcorrection - lagophthalmos, corneal punctate keratopathy | Infection - redness, swelling, discharge | Bleeding - blood | Scarring - cicatricial tissue | Retrobulbar hemorrhage - blood, IOP increase that can damage the optic nerve and decrease ocular perfusion resulting in a CRAO
WORK-UP Thorough history. Slit lamp examination
TREATMENT
Urgent treatment is required for RBH. Surgical decompression management is a priority: Lateral canthotomy with cantholysis | Inferior lateral orbitomy
Medical management may be used to reduce IOP (IV acetazolamide)
Over- or under-correction following blepharoplasty may be addressed with further eyelid surgery
Infections can be treated with topical and/or systemic antibiotics
FOLLOW-UP Daily for most complications
ADDITIONAL LAB | TESTS A CT scan may be indicated in the presence of a retrobulbar hemorrhage
ETIOLOGY Blepharoplasty surgery
DIFFERENTIAL DX None
NOTES Retrobulbar hemorrhage is a sight-threatening emergency