At 40 I have what I feel is already very unattractive and low, droopy eyelids. I know that this can cause vision issues and was curious as to who determines when this procedure should be done? Can/do you or does an ophthalmologist make the determination?
What you are describing is visual field deficits which can be produced with excessive skin of the upper lids. The ophthalmologist or optometrist can determine visual field deficits. The timing of upper eyelid surgery can be a medical decision, but, in my practice, patients often seek my services for blepharoplasty surgery of the upper eyelids for cosmetic reasons even before visual field deficits can be detected. At 40 you will unlikely have enough skin drooping to justify the procedure based on visual field results only. However, based on your description, I would suggest cosmetic repair of the upper eyelids which will have the same effect.
Posted by Dr. Philip Schoenfeld