Dry eye syndrome and other tear film abnormalities.

The goal of cosmetic blepharoplasty is to obtain an improvement in the appearance of the eyelids without causing functional or symptomatic alterations in the patients. Patients with undiagnosed problems in tear production who have cosmetic blepharoplasties are a common source of extremely dissatisfied patients with alarming ocular symptoms. Although keratoconjunctivitis sicca is the most common manifestation of an abnormal tear film state, there are other conditions of which the eyelid surgeon should be aware. Knowledge of methods used in the diagnosis of states of tear deficiency will allow the surgeon to better select candidates for cosmetic eyelid procedures.