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Oculoplastic Eye Problems

Please click here to view the full Oculoplastic Eye Problems Commissioning Statement.  

Oculoplastic procedures are not routinely commissioned as many are for cosmetic reasons.  However there are a number of conditions which affect vision and functionality affecting activities of daily living and quality of life which may be considered via IFR for surgical correction.

The following eyelid surgery procedures will NOT be commissioned unless there is any diagnostic uncertainty:

The following conditions are NOT routinely commissioned but there are specified criteria which may be considered by IFR for referral and treatment in secondary care:


Background: Ectropion is a condition, typically a consequence of advanced age, in which the eyelid is turned outwards away from the eyeball.

Policy: Ectropion is not routinely commissioned unless:


Background: Epiphora is an overflow of tears onto the face. A clinical sign or condition that constitutes insufficient tear film drainage from the eyes in that tears will drain down the face rather than through the nasolacrimal system.

Policy: Refer to the IFR Panel for watery eyes surgery when, despite undergoing conservative management, the patient is experiencing a daily impact of significant watering of the eyes indoors and outdoors affecting visual function and / or interfering markedly with quality of life.

Chalazion/Meibomian cyst

Background: A chalazion is a slowly developing lump that forms due to blockage and swelling of an oil gland in the eyelid.

Policy: Removal of chalazion is not routinely commissioned. Cases may be considered by the IFR if:


N.B. for diagnostic uncertainty or suspicious symptoms to be referred under the 2 week wait.


Background: Blepharitis is a common condition where the edges of the eyelids (eyelid margins) become red and swollen (inflamed).

Policy: Referral to secondary care for Blepharitis is NOT routinely commissioned. Refer to IFR if symptoms are persistent and have exhausted antibiotic therapy.  If lids persistently swollen consider alternative diagnosis e.g. malignancy and refer under the 2 week referral wait.

To submit an application to the CCG's Individual Funding Request Panel, please click here for further information.