Both gold weights and platinum chains are small implants that help the eyelid to close. They are used in patients with poor eyelid closure (such as facial palsy).

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Historically eyelid weights have been made of gold. It is usually in one piece and is less dense that platinum as so requires more volume (i.e. gold weights are normally larger to achieve the same eyelid closure). Allergies to gold have been reported although this is quite rare.

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Platinum chains tend to be thinner and less bulky as they have a higher density. The platinum chain also conforms to the shape of the eyelid, which can make it less prominent, particularly using heavier weights. Both gold and platinum are used routinely.

To place the weight inside the eyelid requires an operation that can often be performed under local anaesthetic. The surgery involves making in incision along the skin crease of the eyelid and placing the weight underneath the skin and muscle. The eyelid is then closed using some stitches that we will take out at between one and two weeks.

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The surgery normally takes about 25 minutes but can sometimes take longer. This type of surgery is usually performed as a day case operation and we normally allow you to go home about 30 minutes after you surgery is finished.

The risk of surgery includes a weight that can be seen through beneath the skin (a prominent weight), infection and exposure of the weight. The weight may migrate with time and can need re-positioning. Very rarely weights can need removing if they are not tolerated or if you develop an allergy.

From the eyelid perspective a weight may cause the eyelid to sit too low (a ptosis) or not give the degree of closure necessary. The weights may flatten the contour of the eyelid. Most of these changes in position can be adjusted with a second operation. The most serious risk of any eyelid surgery performed is damage to your eyesight. Fortunately this risk is extremely rare.

We advise that you use an antiobiotic ointment after the surgery (see below) to help reduce the risk of infection.

The eyelids will be bruised after surgery and you may have some bloodstained tears which is quite normal initially. You should avoid any strenuous activity including lifting heavy objects for a least a week and avoid swimming for three weeks after surgery.

We advise that you apply ice compresses to the eyelids after surgery for three times a day for 5 minutes each time. This is to help reduce the bruising.

We normally see you after surgery to check the position of the eyelid.

Usually patients are quite anxious after having surgery near their eyes and most problems do settle with time. Problems that require immediate attention are the onset of new double vision, loss of vision and pain that cannot be controlled with regular painkillers. In particular if the eyelid swells up and you cannot open your eye then this requires an urgent review. Please refer to the emergency contact page (in contacts).

Author: Mr Jonathan Norris FRCOphth