Eye & Oculoplastic Surgery
Blepharophimosis
Surgery for blepharophimosis, a condition present from birth in which the eyelid openings are narrow and the upper eyelids droop.
Consult Dr. Raman Mittal ↗
View before & after photos
Illustrative image · not a patient resultOverview
About Blepharophimosis
Blepharophimosis affects the position and opening of the eyelids. A careful eyelid examination is needed before any treatment is planned.
When to see a specialist
- 01A known or suspected diagnosis of blepharophimosis
- 02Narrow eyelid openings or drooping eyelids
- 03A referral for oculoplastic assessment
Whether treatment is suitable can only be decided after a consultation and examination.
Your doctor
Dr. Raman Mittal
Ophthalmology • Oculoplastic Surgery
- MBBS
- DNB – Ophthalmology
- Fellowship in Oculoplasty
Ophthalmologist and oculoplastic surgeon. He treats problems of the eyelids, tear ducts, orbit and eye socket, including cosmetic and reconstructive surgery around the eye.
Your consultation
What happens at the consultation.
At the first visit the doctor listens to your concern, takes a medical history and examines you. Not everyone who comes for a consultation needs a procedure.
Treatment planning
How the plan is decided.
Treatment may be carried out in more than one stage. The order and timing depend on age and the eyelid findings.
- 01
Your anatomy
- 02
Examination findings
- 03
What you want to change
- 04
General health
In detail
Blepharophimosis: what to know.
What blepharophimosis is
Blepharophimosis syndrome (BPES) is a condition present from birth with four typical features.
- Narrow eye openings, drooping upper eyelids, a small fold of skin rising from the lower lid at the inner corner, and a wide distance between the inner corners of the eyes.
- It is caused by a change in the FOXL2 gene. It can run in families, or appear for the first time in a child with no family history.
- In one type, it is also associated with early loss of ovarian function in women.
Why early assessment matters
- Children with BPES are more likely to need glasses, and to develop a squint or a lazy eye (amblyopia).
- If the drooping lids block the pupil, vision may not develop normally, and earlier surgery may be needed.
- Girls are also referred for hormone assessment, and families are offered genetic counselling.
Treatment
- Surgery is usually done in stages. Commonly, the inner corners are corrected first, at around three to five years of age, and the drooping lids about a year later.
- If the drooping lids threaten vision development, they may be lifted first.
- The eyelids are lifted either by tightening the lifting muscle or with a sling to the forehead muscle, depending on how well the muscle works.
The operation and recovery
- Children have a general anaesthetic, usually as a day case.
- Most children need about a week off school and avoid swimming for about two weeks. A follow-up visit is usually after one to two weeks.
- Further surgery is more likely when the operation is done at a young age.
Risks
Every operation carries some risk. Your doctor will go through the risks that apply to you before you decide.
- The eyelids may end up slightly too high or too low, or uneven.
- Bleeding, infection and scarring.
General information, checked against published guidance (September 2026). It does not replace an individual consultation; your doctor will advise on your own case.
Sources: MedlinePlus Genetics (NIH): BPES · EyeWiki (AAO): Blepharophimosis syndrome · Evelina London Children’s Hospital NHS
Before & After
Blepharophimosis Results
Photographs of patients treated at I·PLAST, published with their consent. Results vary from patient to patient.
Blepharophimosis
Before surgery and after each stage of treatment for blepharophimosis.
Specialist: Dr. Raman Mittal
About this treatmentBefore
After stage 1
After stage 2
Results vary between patients. These photographs show individual cases and cannot predict the result for anyone else.
Considering this treatment?
Book a consultation to find out whether it is suitable for you.
What to expect
From first visit to follow-up.
- 01
Consultation
Tell the doctor what concerns you and ask your questions.
- 02
Examination & Planning
The doctor examines you and explains the options, including their limits.
- 03
Treatment
Carried out only if it is suitable for you and you decide to go ahead.
- 04
Follow-Up
Check-ups after treatment to review healing and any next steps.
FAQs
Common questions.
This can only be decided after a consultation and examination. The doctor will go through your concern, your medical history and the options available.
The doctor asks about your concern and medical history, examines you, and discusses what you hope to change and whether treatment is advisable.
Dr. Raman Mittal sees patients for this treatment at I·PLAST.
Yes. If treatment is planned, the doctor will explain aftercare, any activity restrictions and the follow-up visits you will need.
Not necessarily. Results depend on your anatomy, the examination findings, your general health and the procedure. Photographs of other patients show their results only.