Eyelid retraction can affect the upper and lower eyelids, as well as any or all of the three lamellae of the lid. Common sources of retraction include inflammation, including thyroid disease, trauma, and iatrogenic causes. Indications for surgical repair include lagophthalmos, exposure keratopathy, dryness, and cosmesis. Surgical repair must address any aspect of anterior or posterior lamellar shortage that may be present while not neglecting other factors at play, including lid laxity, negative eyelid vector, and muscle weakness. Multiple surgical techniques, including flaps, spacers, and grafts, as well as combinations of these, can be utilized to successfully address the multiple components contributing to eyelid retraction. Careful preoperative evaluation and surgical planning cannot be overemphasized in the pursuit of satisfactory outcomes for patient and surgeon.
KeywordsEyelid retraction Exposure keratopathy Cicatricial Full-thickness skin graft