Extraocular disorders and their surgical management can significantly influence corneal astigmatism and higher-order aberrations (HOAs). This review aimed to evaluate the relationship between extraocular conditions, their surgical correction, and subsequent changes in corneal astigmatism and HOAs. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science, including studies published between 1992 and 2024. Search terms included astigmatism, eyelid surgery, thyroid eye disease (TED), orbital decompression, blepharoplasty, chalazion, dermatochalasis, ptosis, pterygium, scleral buckle, and HOAs. The reviewed literature demonstrates that a wide spectrum of extraocular disorders (such as ptosis, dermatochalasis, TED, chalazion, and pterygium) are associated with clinically significant changes in corneal astigmatism and HOAs. These alterations are affected by factors including lesion size, anatomical location, and the type of surgical intervention. For instance, ptosis surgery may either reduce or induce astigmatism depending on patient age and surgical technique, while chalazion excision and pterygium removal frequently lead to meaningful reductions in astigmatism and HOAs, particularly in cases involving larger lesions. The timing of postoperative evaluation and surgical approach plays a critical role in the magnitude and persistence of these optical changes. Awareness of the impact of extraocular diseases and their surgical treatment on corneal astigmatism and HOAs is essential for accurate interpretation of refractive changes, postoperative follow-up, and optimal patient management.
Keywords: astigmatism; blepharoplasty; chalazion; eyelid surgery; higher-order aberration; ptosis.
How eye and eyelid conditions and their surgeries can change vision by affecting the front of the eye. This article looks at how problems with the outer parts of the eye, such as the eyelids or tissues around the eye, can change the shape of the cornea, the clear front surface of the eye. When the cornea’s shape changes, it can cause vision problems such as blurriness or distortions. These problems are often related to astigmatism or higher-order aberrations, both of which affect how clearly a person sees. Some common conditions, such as droopy eyelids (ptosis), excess eyelid skin (dermatochalasis), thyroid-related eye disease, or growths like pterygium, can press on the eye and change the cornea’s shape. Even small lumps like chalazion, which result from a blocked oil gland in the eyelid, can distort the cornea. The good news is that surgery to treat these conditions often helps the cornea return to a more normal shape. This article reviews many scientific studies to examine how these conditions and their surgeries affect the cornea. In most cases, surgery leads to an improvement in vision by reducing astigmatism or other corneal distortions. However, the effects may vary depending on the patient’s age, the size of the lesion, and the surgical technique used. In some cases, surgery may temporarily worsen corneal changes before improvement occurs. Understanding these changes is important for eye care professionals, as it helps guide treatment planning and determine the appropriate timing for procedures such as cataract surgery or vision correction. The article recommends waiting several months after eyelid or pterygium surgery before performing procedures that rely on corneal measurements, to ensure that the eye has fully stabilized.
© The Author(s), 2026.