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Clinical Challenges
June 2001

Should Formal Ophthalmologic Evaluation Be a Preoperative Requirement Prior to Blepharoplasty?

Author Affiliations




Arch Otolaryngol Head Neck Surg. 2001;127(6):719-722. doi:10.1001/archotol.127.6.719

Formal ophthalmologic evaluation should be a preoperative requirement prior to blepharoplasty.

Blepharoplasty has become a common cosmetic procedure practiced by many specialties. As with any cosmetic procedure, there is a fine balance between positive adjustments of form without any alteration in function. The full evaluation of patients for blepharoplasty includes a multitude of tests designed to select appropriate candidates for the procedure and exclude those who might be predisposed to any adverse functional or cosmetic outcome. Ophthalmologic expertise adds validity to the preoperative assessment, and an opthalmologic evaluation is often performed routinely more for medicolegal purposes than to change operative management. Moreover, it has become dogmatic in many training institutions to include ophthalmologic evaluation as a part of the standard evaluation prior to blepharoplasty. Many, however, feel that this extra step in the preoperative assessment may be redundant: the test result rarely alters the decision to perform blepharoplasty, and the usefulness of the tests available compared with proficient clinical assessment has been questioned. As blepharoplasty expertise and surgical techniques have evolved, it appears that a consensus regarding the gold standard for preoperative evaluation has become less concrete.

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