Oculoplastics FAQs

Oculoplastic surgery procedures involve the eye socket, eyelids, tear ducts, and face. Some oculoplastic surgeries are cosmetic, meaning the procedures improve the patient’s appearance. Other procedures are reconstructive and medically necessary to protect vision, eye comfort, and eye health. Some oculoplastic procedures are both medically necessary and cosmetic, addressing a medical problem while enhancing aesthetics.

There are several types of oculoplastic surgery procedures, including eyelid surgery, tear duct surgery, orbital surgery (of the eye socket), eyebrow and forehead lifts, and face lifts and implants.

Ophthalmology is the medical specialty focused on eye health, vision, and the treatment of eye diseases such as cataracts, glaucoma, and macular degeneration. Oculoplastics is a subspecialty within ophthalmology that specifically focuses on the structures around the eye, including the eyelids, tear ducts, eye socket, and surrounding facial areas.

Our Jacksonville eyelid surgery experts and caring staff will help you determine whether your eyelid surgery may be covered by insurance. Whether insurance covers eyelid surgery depends on your coverage and the level of benefits your insurance provides.

As a general rule, insurance does not cover cosmetic surgery. However, if your eyelids droop enough to encroach on your field of vision, the blepharoplasty procedure may be covered as a “medically necessary” surgery. A visual field exam may be ordered to determine how much the upper lid interferes with your vision.

Some healthcare insurance companies will cover eyelid surgery if three main requirements are met:

• Documented photo of eyelid droop or dermatochalasis (excess skin above the eyelid must be within 2mm of the pupil).
• Documented clinical exam by a physician.
• At least 30% improvement in a superior visual field test with eyelid taped compared to without.