When redundant upper eyelid skin results in obstruction of vision, it’s more than a cosmetic issue. Patients often have excess skin, which obstructs vision superiorly and laterally. Under these circumstances, excess upper eyelid skin can actually cause significant functional problems. For instance, this can create problems when driving a motor vehicle and this can be potentially dangerous. When this happens insurance carriers will occasionally view upper lid blepharoplasty as medically necessary and cover its expense.
Before insurance carriers cover the expense of blepharoplasty they require that certain criteria be met. These include documentation of symptoms and physical findings associated with visual field obstruction. In addition, visual field studies that demonstrate visual field obstruction are critical to insurance approval.
Visual field studies are typically performed by an ophthalmologist or optometrist. The study is performed by measuring the patient’s response to a series of flashing lights. The patient’s responses are recorded and a computer- generated report is made. This report will demonstrate any visual field defects that the patient may have. The initial study is followed by a secondary study in which the upper eyelids are taped in an upward direction. Improvements in the results of visual field studies with the upper lids taped as opposed to untaped would indicate that blepharoplasty would benefit the patient.
Once the evaluation is complete, a prior authorization letter is sent to the insurance company for determination of medical necessity. The probability of insurance approval varies from carrier to carrier. It’s safe to say that insurance companies are approving fewer blepharoplasties as time goes on.
If you are in need of a blepharoplasty and/or extra eyelid skin is obstructing your vision, you may benefit from a consultation with a board-certified plastic surgeon at Aesthetic Surgical Images.
