When is Eyelid Surgery Covered by OHIP?

Your eyes are one of the first things people notice about you. They also show signs of aging sooner than any other part of your face. Loose skin, fat deposits, and puffiness around the eyes can all make you look older and more tired. In extreme cases, they can even impair your vision.

Blepharoplasty (eyelid surgery) can repair these issues and restore a youthful appearance. What you may be wondering is whether your surgery can be covered by OHIP.

The answer is that it’s possible, but only under limited circumstances.

When Eyelid Surgery IS Covered

As a general rule, cosmetic procedures are not covered by OHIP. Exceptions are only made if the surgery is deemed medically necessary.

With blepharoplasty, OHIP will cover an upper lid procedure if skin hanging across your eye restricts your vision by 50% or more. The fact that it bothers you or feels uncomfortable is not enough to secure coverage- the drooping must be low enough to affect your ability to see.

One condition that can meet this criteria is ptosis, which occurs when the border of your upper eyelid descends to a lower position than normal. In extreme cases, the sagging lid can cover your pupil and prevent you from using that eye properly.

Children who have ptosis are usually born with it, whereas adults may develop it due to aging, eye trauma, or an underlying neurological condition. Left untreated, it can cause problems that include impaired vision, eye strain, headaches, and pain in the brow area.

Ptosis can usually be treated surgically, but your ophthalmologist will do a complete eye exam to determine the cause before recommending treatment. They will also advise you whether your surgery is eligible for OHIP coverage.

When Should You Consider Cosmetic Eyelid Surgery?

If you don’t have ptosis or any other condition that makes eyelid surgery medically advisable, the decision to have it done is a personal one. If excess skin and fat deposits around your eyes have a negative impact on the way you feel about yourself, talk to an oculoplastic surgeon who can answer your blepharoplasty questions and help you make the right decision. 

How is Eyelid Surgery Performed?

With upper eyelid surgery, incisions are made in the natural folds of your lid to remove fat, excess skin, or loose muscle. While some fat will be redistributed to retain a natural look, the majority will be removed. Your surgeon will then close the incisions with ultra-fine sutures so that they are virtually unnoticeable after healing. What WILL be noticed is how your eyes have a brighter, more alert appearance. 

If you are having your lower lids done, the incisions are made directly below the lash line to eliminate excess skin. If you only need fat removed, the incisions may be made behind your lower lids, a procedure known as transconjunctival blepharoplasty. The goal is to restore the smoothness and tone of the skin around your eyes, giving you a healthy and youthful appearance.

Do You Have Questions About Eyelid Surgery?

Although OHIP will only cover your eyelid surgery if it’s medically recommended, there may come a time when you decide to have it done to boost your appearance and self-esteem. UELC has eye clinics in Vaughan, Toronto, and Brampton where you can have your surgery, either alone or in conjunction with other cosmetic procedures like browpexy. If you have any questions or would like to schedule a consultation, call 416-653-8352.

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