Every three to five years, NHS Lancashire and South Cumbria ICB review its clinical policies to ensure they reflect the latest evidence-based guidance and best practice. We are currently reviewing the following policies and would welcome your views on the proposed changes.
Please share your feedback by completing the short questionnaire.
Blepharoplasty is a type of surgery that repairs droopy eyelids and may involve removing excess skin, muscle, and fat.
The updated blepharoplasty policy introduces a DVLA-aligned visual field threshold and expands eligibility to include a broader range of eyelid pathologies. Subjective measures have been removed in favour of objective visual field assessments, and ocular surface disease has been reinstated. This may mean that some people are no longer eligible for this procedure.
The proposed wording of the updated policy is:
1. Blepharoplasty is not commissioned for aesthetic purposes.
2. If a patient has symptoms attributable to dermatochalasis which have not responded to conservative management, upper lid blepharoplasty is commissioned for:
a. Visual field restriction clearly caused by excess skin, measured using Esterman/driving fields, whereby the eyelids impinge on the individual’s visual fields reducing that field to 120° or less laterally (with a minimum of 50° to left and to right) and/or 20° or less superiorly
OR
b. Eyelid or eyelash pathology caused by excess skin (for example periocular dermatitis, wick syndrome)
OR
c. Ocular surface disease caused by excess skin.
OR
d. Severe unilateral dermatochalasis causing significant visual loss and functional impairment.
OR
e. There is photographic evidence of frontalis overaction caused by dermatochalasis.
3. Brow lift is commissioned as an adjunct to blepharoplasty when:
a. Brow ptosis is a major contributor to the reduced visual field
b. There will be significant uncorrected visual field loss if blepharoplasty alone is carried out.
c. Lower lid blepharoplasty is not routinely commissioned.
4. The following are excluded and are therefore not restricted by this policy:
a. Thyroid eye disease
b. Ptosis correction
c. Surgical treatment of lower lid pathology, for example, ectropion.
d. Malignancy
e. Children aged under 18 years
Please note this survey closes at midnight on Friday 26 December 2025.