Cyprus abolishes 8 mm criterion for GESY approval of blepharoplasty

The Cyprus Health Insurance Organisation (HIO) has changed the procedure for approving blepharoplasty operations under the General Healthcare System (GESY) and notified the system’s plastic surgeons and ophthalmologists. The main change is the abolition of the criterion requiring the function of the muscle that lifts the upper eyelid to be less than eight millimetres.

The measurement must still be included in the application, but it is no longer a mandatory condition for approval of the operation. Coverage still applies only to procedures on the upper eyelid where a functional problem has been confirmed: GESY does not cover operations performed solely for aesthetic reasons.

Prior approval remains mandatory. For insured persons aged between 9 and 80, the application must confirm a reduction in peripheral vision of at least 30% according to visual field testing, as well as an MRD1 measurement below three millimetres. In cases of excess upper-eyelid skin, it must additionally be proven that the visual field is narrowed specifically because of it and not for another reason.

The report by the doctor who conducted the examination must state the percentage reduction in peripheral vision and include a signature, stamp and date. Patients over 80 require photographic documentation—two photographs, one with the eyebrows raised and one without. A separate category covers children under nine with upper-eyelid ptosis; photographs are also mandatory for them.

If a patient has a neurological condition, such as facial nerve palsy, the application must include a neurological assessment and a complete medical history with information about previous operations. The HIO separately clarified that lower-eyelid operations are considered aesthetic and are not covered by GESY.