Treating Prominent Eyelid Veins

Cosmetic Question: I have a strange large vein running done the side of one lower lid. Can that be fixed?

Cosmetic Answer:

Yes. The lower lid has a complex arcade of veins going through the lower lid muscle. Sometimes a few veins are really large – and look unsightly.

There are 3 ways to treat these prominent veins:

Surgery – this means a small office procedure. A drop of novocaine numbs the skin. A tiny incision is made over it, the vein is then located and tied off with fine absorbing sutures – and then cut in half. This has to be done with magnification – and apart from plastic surgeons and ophthalmologists, few doctors will have fine enough equipment. This is the most effective treatment.
Cautery – the skin is numbed and a tiny needle is put into the vein. The metal end of the needle is touched with a cautery. The current runs into the vein and seals it off. It can be difficult to put in accurately and this approach can burn the skin. In addition, the vein can be sealed off, but then open up again. So it is less certain a treatment than surgery.
Sclerosant – veins in the legs are commonly treated with irritating solutions called sclerosants. The eyes can be treated the same way – by injecting a small amount of sclerosant. This approach in my opinion is too risky – because if the injected sclerosant flows back to the eye it can damage the eye itself.

In general I prefer surgery because it takes more time and effort but it is effective and safe. Cautery is also a reasonable option. However, generally I avoid sclerosants except in unusual circumstances.

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Copyright E Morgan July 2014