Drs Burke and Wang have provided a balanced and informative resolution to an old problem for facial plastic surgeons. The prevention of dry eye syndrome by recognizing potential problem patients prior to blepharoplasty is a worthy challenge. Dry eye syndrome is a very debilitating disorder. When it occurs following blepharoplasty, dry eye syndrome can totally eclipse any aesthetic benefit from the procedure and can become the focal point of the patient's life. For this reason, ophthalmologic evaluation has been recommended by some training institutions as essential prior to blepharoplasty.