Expert Care for the Structures Around Your Eyes

What happens: eyelid examination and photography to document baseline appearance; visual field testing if the procedure is on functional grounds; a discussion of realistic outcomes (final results assessed at 3 months); consent; and a review of medications, especially blood thinners.

What to tell us: all blood-thinning medications (warfarin, apixaban, rivaroxaban, aspirin, clopidogrel, ibuprofen); any history of dry eye, as surgery temporarily worsens it; if you wear contact lenses; any previous eyelid or facial surgery; any thyroid disease, which requires specific planning.

What to bring: your appointment letter, an up-to-date list of all your medications, your current glasses, and a responsible adult to drive you home.

Morning of surgery: eat and drink normally (local anaesthetic, no fasting); arrange transport as you cannot drive; wear clothing that buttons at the front; allow 2 to 3 hours total; no eye makeup, foundation or face cream; no contact lenses on the day; no perfume or aftershave.

1. Arrival and preparation: arrive at the time specified. The surgeon marks the eyelids with a skin marker before beginning.

2. Anaesthetic: local anaesthetic is injected into the eyelid, a brief sting followed by complete numbness within 30 to 60 seconds. You will be awake throughout.

3. The procedure: you may feel pressure or movement but should not feel pain. You may hear cutting and cautery instruments, which is normal. Sutures are placed at the end.

4. Going home: you are discharged with your escort, antibiotic ointment, and written aftercare instructions. Cold compresses start immediately at home.

Time required: the surgery itself may take 30 to 90 minutes; please allow 2 to 3 hours for your visit. You must not drive yourself home.

Immediately after: rest in the recovery area before discharge; your eye may be padded or shielded; you will need an escort to drive you home; begin cold compresses as soon as you get home; take regular paracetamol and avoid ibuprofen, which increases bleeding.

The golden rules: cold compresses every hour for the first 48 hours (10 to 15 minutes each); sleep with your head elevated on 2 to 3 pillows for one week; apply antibiotic ointment to the suture lines 3 to 4 times daily; attend your suture removal appointment; do not rub or touch the eyelids; no eye makeup for 2 weeks; no contact lenses for 2 weeks; no bending or heavy lifting for 2 weeks.

Eye drop / ointment technique: wash your hands; tilt your head back and pull the lower lid down; look up and do not let the tip touch the eye; apply as directed; close the eye gently for 60 seconds; press the inner corner for 60 seconds; wait 5 minutes between different drops.

Timeline: Day 0 to 1, significant swelling begins, lids feel tight, cold compresses every hour while awake. Days 2 to 3, bruising and swelling peak, which is normal and expected. Day 5 to 7, bruising starts to disperse, suture removal if non-dissolvable. Week 2, most bruising resolved, resume most normal activities. Weeks 4 to 6, incision lines still pink and slightly raised, resume all activities including exercise. Month 3, final result assessed, incision lines faded.

Restrictions: no swimming for 3 weeks; no hot tubs or saunas for 3 weeks; no eye makeup for 2 weeks; no strenuous exercise, bending or heavy lifting for 2 weeks; no driving until vision is clear and you feel safe, usually after suture removal.

Call 01732 756789 immediately if you have: a sudden rapid increase in pain and hard swelling (possible haematoma requiring urgent drainage); rapidly increasing hard painful swelling (orbital haematoma, a rare emergency); sudden loss of vision or visual disturbance; or signs of infection after day 3 (increasing redness, warmth, pus, fever).

Contact us within 24 hours for: wound edges that have separated or sutures that have come loose; discharge that looks like pus rather than clear fluid; significant dry eye causing corneal pain or light sensitivity; or severe or worsening chemosis (jelly-like swelling of the eye surface).

Normal and expected: significant bruising and swelling peaking at days 2 to 3; lids feeling tight especially on waking; a watery eye during the first 2 weeks; mild asymmetry between the lids in the first 6 weeks; chemosis resolving over 2 to 3 weeks.