Lower eyelid retraction is defined as descent of the lower eyelid below the normal position with showing of the lower sclera (the white part of the eye). This can happen from aging or as a complication of cosmetic or reconstructive lower eyelid surgery. Some patients are born with such lower eyelid position. Patients may experience dryness, irritation, excess tearing, eye redness, discomfort and blurry vision. The shape of the eye is often changed or distorted. Some patients may not like the appearance. In the upper eyelid retraction can lead to inability to fully close the eyes. This may result from conditions such as thyroid eye disease or complications of droopy eyelid surgery.
Correction of retraction involves lowering of the upper or raising of the lower eyelids, depending on the specific problem. Skin or tissue grafting may be necessary if the problem resulted from overly aggressive tissue removal during blepharoplasty, or as a result of aging. To elevate the lower eyelid, a graft is placed on the inside part of the lid, so the resultant position of the lower eyelid is higher on the eye (no scleral white show). This also makes the eye shape more almond rather than round.