At 40 I have what I feel is already very unattractive low droopy eyelids. I know that this can cause vision issues and was curious as to what determines when this procedure should be done. Can you or does an ophthalmologist make the determination?
If you wish to have work done on your eyelids and get third party reimbursement such as insurance or Medicare if that is the case, you have to get work done by an ophthalmologist with regard to lateral temporal field visual cuts. If it can be shown objectively by an ophthalmologist that you have restriction of vision or problems reading, sometimes you can get third party reimbursement. However, at 40 years old, it is probably unlikely that you are going to get reimbursement from a third party as the people who are involved with this try very hard to avoid any kind of payment if at all possible.
Certainly at 40 years old, if need be, we can do corrective surgery and make you look a lot better and improve your vision. Specifically, though, regarding the question, an ophthalmologist has to do visual studies to determine whether a third party involvement for reimbursement is needed.