Thank you for your question.
You submitted a question without a photo but in the substance of your question, you’re
asking is it alright for you to wear rigid gas permeable lenses after undergoing ptosis
surgery.
And you state that you’ve been wearing these lenses for 30 years and naturally, you developed
ptosis and you’re concerned about recurrence after wearing the lenses.
Well, I can share with you what would be my counseling to patients in my practice who
present similar situations like yourself.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Eyelid ptosis is a very common issue that we deal with in our practice as well as Asian
eyelid surgery and of course the combination of eyelid surgery with eyelid ptosis.
So I can basically breakdown for you what are the variables that may have contributed
to your ptosis.
And to begin with, it is certainly a well-known association between the wearing of hard contact
lenses and the causing of ptosis.
The conceptual theory is that when the eyelid is blinking and the muscle called the levator
muscle is rubbing against the contact lens, that muscle tendon called the levator aponeurosis
can become thinner and result in some degree of ptosis.
And there have been also an association with other variables of different types of contact
lenses but essentially, there is a known association.
Now, you’ve been saying that you’ve been wearing these lenses for 30 years and you’re
middle aged.
Well, there are also other causes of ptosis that are not uncommon at this stage of your
life and the term for that is called involutional ptosis.
And this is a situation where the muscle that lifts the eyelid, again the levator aponeurosis,
can become thin or stretched.
So it’s more of an age-related issue.
So the question of course is what do you do to try to maximize the longevity of your surgery?
Well, that’s a challenging question because you are dealing with clearly an important
part of your visual function is to wear these contact lenses.
A lot of times, people who wear rigid gas permeable lenses like yourself are people
who have significant astigmatism or conditions such as keratoconus and basically, their cornea
needs a proper lens in order to be able to see very well.
A lot of times, if people don’t need contact lenses or can wear glasses, well then they
choose to wear glasses.
But I would suspect that if you have a type of condition where the contact lens is necessary,
well then you’re just going to have to accept that a certain amount of wear and tear of
your eyelid tissue moving forward may still transpire.
Again, it’s a matter of balance.
So I think that of course, this is a coordinated effort between your oculoplastic surgeon who
performed your surgery and your ophthalmologist who might be able to offer you maybe softer
lenses or other options in the field of ophthalmology whether you’re a candidate possibly for
laser vision correction or other alternatives.
But the point is that, yes, there is a risk of the foreign body or contact lens wearing
down the eyelid tissue so that you may need to deal with the ptosis again.
Certainly, it is also important for you to remember to use lubricating drops that can
hopefully help you with some of the frictional aspects of the interface between the eyelid
and the contact lens and of course, good ocular hygiene, proper contact lens hygiene and other
things that can at least minimize the amount of potential inflammation and irritation that
can be associated with wearing of contact lenses.
And of course, as we get older, we also understand that the eyes can get a little more dry.
And that’s another variable that has to be factored in.
And as I said earlier, involutional ptosis, age-related thinning of the tissue can still
happen regardless of the presence of the contact lens.
So it’s not necessarily always a direct cause and effect but it can be multiple variables
contributing to the ptosis.
So I hope that was helpful, I wish you the best of luck and thank you for your question.