Scleral Show

What Is Scleral Show?

Scleral show refers to a condition where an excessive amount of the white part of the eye (sclera) is visible, usually below the iris. Instead of the lower eyelid touching or sitting just at the edge of the iris, the eyelid sits too low, exposing more white area than normal.

Mild scleral show can make the eyes look larger, but moderate to severe cases often create a tired, startled, or unnatural appearance, especially after cosmetic procedures.

It is one of the most frequently addressed eye-area concerns in Korean aesthetic clinics.

Why Does Scleral Show Happen?

Natural Anatomy

Some people naturally have lower eyelids that sit slightly lower than average.

Aging

As collagen decreases and skin elasticity weakens, the lower eyelid can drop, creating scleral exposure.

Lower Eyelid Retraction

This happens when:

• Lower lid muscles weaken
• Tendons stretch
• Skin becomes tight or scarred

Post-Surgical Causes (Most Common)

Scleral show often occurs after:

• Lower blepharoplasty
• Eye bag removal
• Aggressive fat removal
• Over-tightening of the lower eyelid skin
• Excessive skin excision
• Issues with canthoplasty
• Scar contracture

This form of scleral show is treatable but requires expert revision surgery.

Types of Scleral Show

1. Mild Scleral Show

• Slightly visible white area
• May look natural
• Often cosmetic only

2. Moderate Scleral Show

• Noticeable lower white sclera
• Eyes may appear rounder or more fatigued
• Common after lower blepharoplasty

3. Severe Scleral Show

• Obvious “rounded” or “pulled down” eye shape
• Often due to strong scar tissue or incorrect surgery
• Needs structural correction

Symptoms Patients Experience

• Eyes look round, tired, or unnatural
• Irritation and dryness
• Difficulty fully closing eyes
• Light sensitivity
• Lower lid feels tight or pulled
• More visible tearing

When scleral show is caused by surgery, symptoms may be more noticeable.

How Korea Treats Scleral Show

Korea is known for advanced revision lower eyelid surgery, which focuses on rebuilding support, releasing scar tissue, and restoring natural eyelid position.

1. Lower Eyelid Repositioning Surgery

Repositions the lower lid upward to its normal height.

2. Canthopexy or Canthoplasty Revision

Tightens and stabilizes the outer corner of the eye.
Used when the eyelid is loose or sagging laterally.

3. Midface Lift / SOOF Lift

Elevates midface tissues to reduce downward tension on the lower lid.

4. Spacer Grafts (Severe Cases)

Uses tissue grafts (usually from ear cartilage or internal tissue) to:

• Lengthen the lower lid
• Reduce tightness
• Correct severe surgical complications

This is the gold standard for major lower lid retraction.

5. Fat Grafting or Fat Repositioning

Fills hollow areas to support the lower eyelid from beneath.

6. Laser or Scar Management

Softens mild scar tissue pulling the eyelid downward.

7. Tear Trough Correction

Smooths sunken areas that exaggerate scleral show.

Who Needs Treatment?

You may benefit from correction if:

• Your eyes look round or unnatural after surgery
• You see white below the iris when you look straight
• You experience dryness, tearing, or irritation
• One lower eyelid sits lower than the other
• You had aggressive eye bag removal
• You cannot fully close your eyes
• Your lower eyelid feels tight, pulled, or inward-turned

How Korean Surgeons Diagnose Scleral Show

A detailed exam includes:

• Lower lid laxity test
• Canthal angle assessment
• Midface volume evaluation
• Scar tissue mapping
• Tear production analysis
• Eye movement tests
• Photo simulation for natural eyelid height

This determines the correct revision method.

Can Scleral Show Improve on Its Own?

Mild Cases

May improve with lubrication, steroid drops, massage, or time.

Moderate to Severe Cases

Usually do not improve without structural correction, especially if due to previous surgery.

Why Korea Is a Global Leader in Scleral Show Correction

• High revision surgery expertise
• Advanced lower blepharoplasty methods
• Emphasis on natural, almond-shaped eyes
• Fine control of canthal repositioning
• Strong experience in fixing eye bag removal complications

Korean surgeons frequently repair cases from overseas clinics that resulted in lower eyelid retraction.