Eyelid Position and Patient-Reported Aesthetic Outcomes Following Administration of Topical Oxymetazoline: A Prospective Cohort Investigation

Background: Topical oxymetazoline hydrochloride 0.1% is a pharmacologic agent for eyelid elevation. Objective: This study investigates changes in eyelid position and patient-reported aesthetic outcomes following topical oxymetazoline. Methods and Materials: A prospective cohort investigation was conducted at a single institution. Participants received one drop of oxymetazoline in each eye. Margin reflex distance-1 and palpebral fissure height were recorded pre-and 15 minutes post-instillation. FACE-Q validated surveys regarding patient-reported upper eyelid appraisal and perceived age were administered pre-and post-intervention and a survey regarding outcome satisfaction was administered post-intervention. Results: One hundred participants were enrolled. The mean age was 52.0 years. Participants predominantly self-identified as female (90%) and white (94%). Following oxymetazoline administration, there were statistically significant increases in margin reflex distance-1 (mean increase 0.8 mm, P<0.001) and palpebral fissure height (mean increase 0.8 mm, P<0.001). Significantly, upper eyelid appraisal Do Not Copy improved by 23.5% (P<0.001) and perceived age decreased by 1.4 years (P<0.003) after oxymetazoline instillation. Overall, 85% of Penalties Apply participants reported 51% or higher outcome satisfaction. There were no reported treatment-associated adverse events. Conclusions: Administration of topical oxymetazoline was associated with statistically significant improvements in eyelid position, upper eyelid appraisal, and perceived age. The majority of participants reported outcome satisfaction.