Doctor, Please make my eyes smaller! 医生，请让我的眼睛更小！

In most instances, patients come in to see me requesting for larger and longer eyes. However, having big and prominent eyes may not always turn out to be attractive. There are some conditions where you can have prominent, 'bulging' eyes which give a stark or stare appearance and this can be pretty daunting. Thyroid Eye Disease and extreme short sightedness are 2 common conditions. Thyroid Eye Disease causes inflammation and swelling of the soft tissue behind the globe thus pushing the eyeball forward. The axial length of the eyeball is much longer in patients with extreme short sightedness, therefore the eyes appear prominent. Besides cosmetic disfigurement, these patients usually suffer discomfort and dry eye due to constant eye exposure.

What can we do to improve the cosmesis and eye comfort for such patients?

In severe cases, the definitive treatment is orbital decompression surgery whereby orbital bones are removed and sculpted to create more bony space to accommodate the globe. In mild to moderate cases, the eyelids can be sutured together to narrow down the eyelid aperture. Other minimally invasive modalities such as Botulinum Toxin A and hyaluronic acid gel filler can also do the trick.

This patient was very distressed with the prominent and stare look. 

She also suffers extreme eye discomfort due to dry eye.

 After narrowing the eyelid aperture, she not only looks better, her eyes also feel more comfortable.

这名患者是很心疼的突出和星空的样子。

她也遭受极端眼部不适，由于干眼病。

缩小眼睑光圈后，她不仅更好看，她也感觉更舒服。

Google Translate:

在大多数情况下，病人来见我，要求较大和较长的眼睛。然而，有大而突出的眼睛可能并不总会有吸引力。有一些条件，你可以有显着的“胀”眼睛能给出一个鲜明的或凝视的外观，这可以是相当艰巨的。甲状腺眼病和极端短视2个常见的情况。甲状腺眼病引起炎症后面的地球从而将眼球向前的软组织和肿胀。眼球的轴向长度更长患者极度近视，因此眼睛出现突出。除了化妆品毁容，这些患者通常患有不适，干眼是由于眼球不断曝光。

我们可以做些什么来改善外观效果和眼睛舒适为此类患者？

在严重的情况下，彻底治疗是眼眶减压手术，从而眼眶的骨头被移除，雕刻，创造更多的骨性空间来容纳全球。在轻度至中度的情况下，眼睑可以缝合在一起，缩小眼睑光圈。等微创方式，如A型肉毒毒素和透明质酸凝胶填充物也可以做的伎俩。