The value of tear film breakup and Schirmer's tests in preoperative blepharoplasty evaluation

The authors published their article on the value of tear film breakup and S chirmer's tests in preoperative blepharoplasty evaluation in 1989. The purp ose of this update is to expand the original article in light of refinement s and experiences in subsequent years. It was concluded in the 1989 article that the abnormal tear film breakup an d Schirmer's tests were not good predictors of possible postblepharoplasty dry eye complications. It was concluded in the retie iv that the anatomy an d the history including scleral show, lagophtholmus, negative vector, snap test, previous surgery, increased blinking, dryness, grittiness and pain we re more important predictors of postoperative dry eye problems than the ocu lar tests. The authors' opinion remains so, and they do less preoperative tear film te sting and place more emphasis on the history and the anatomy as predictors of potential problems. In this follow-up to the 1989 article, the authors i nclude a sun ey from several surgeons as to how they evaluate their patient s for elective aesthetic blepharoplasty, which in large measure confirms th e authors' practice.