Objective To explore the effect of eye mask simulation combined with continuous nursing on postoperative coping and adaptive capacity and double eyelid improvement effect in patients undergoing double eyelid surgery. Methods A total of 92 patients undergoing double eyelid surgery admitted to Guangyang District Ophthalmology Hospital of Langfang City from May 2024 to May 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 46 patients in each group. The control group received conventional nursing, and the observation group received eye mask simulation combined with continuous nursing. The postoperative coping and adaptive capacity, double eyelid improvement effect, self-care ability and complications were compared between the two groups. Results The scores of postoperative coping and adaptive capacity in the observation group at 1 and 3 months after operation were higher than those in the control group (P <0.05). The score of double eyelid improvement effect in the observation group at 3 months after operation was higher than that in the control group (P <0.05). The scores of self-care ability in the observation group at 3 months after operation were higher than those in the control group (P <0.05). The incidence of complications in the observation group (4.35%) was lower than that in the control group (23.91%) (P <0.05). Conclusion The application of eye mask simulation combined with continuous nursing in patients undergoing double eyelid surgery can improve their postoperative coping and adaptive capacity as well as self-care ability, effectively enhance the double eyelid effect, and reduce complications.