Kalin-Hajdu, Evan M.D.; Wang, Qinyun M.D.; McLeod, Stephen D. M.D.; Vagefi, M. Reza M.D.
Department of Ophthalmology, University of California, San Francisco, San Francisco, California, U.S.A.
Accepted for publication July 20, 2017.
Supported in part by an institutional grant from Research to Prevent Blindness.
The authors have no financial or conflicts of interest to disclose.
Address correspondence and reprint requests to M. Reza Vagefi, M.D., Department of Ophthalmology, University of California, San Francisco, 10 Koret Way, San Francisco, CA 94143. E-mail: [email protected]
doi: 10.1097/IOP.0000000000000994
A 71-year-old Caucasian woman presented 2 weeks following bilateral internal levator resection and upper and lower blepharoplasty. A higher than desired left upper lid was noted for which downward massage was instructed. At postoperative week 6, the patient presented with best-corrected visual acuity (VA) in the left eye (OS) of 20/100 down from pre- and immediate postoperative VA of 20/40. Retinoscopy revealed superior irregular astigmatism OS confirmed on corneal topography that was not present on prior studies (Fig. A Fig. B ). This is the first report of corneal warpage due to aggressive lid massage, to the best of our knowledge. As with contact lens wear, the changes appear to be reversible.
Corneal topography demonstrates corneal warpage with superior steepening of the left eye from aggressive lid massage (A) . Corneal warpage resolves 1.5 months later after lid massage is stopped (B) .
© 2018 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc. 
