Blepharochalasis

Blepharochalasis is an inflammation of the eyelid that is characterized by exacerbations and remissions of eyelid edema, which results in a stretching and subsequent atrophy of the eyelid tissue, leading to the formation of redundant folds over the lid margins. It typically affects only the upper eyelids, and may be unilateral as well as bilateral.^[1]

Pathophysiology

Blepharochalasis results from recurrent bouts of painless eyelid swelling, each lasting for several days. This is thought to be a form of localized angioedema, or rapid accumulation of fluid in the tissues. Recurrent episodes lead to thin and atrophic skin. Damage to the levator palpebrae superioris muscle causes ptosis, or drooping of the eyelid, when the muscle can no longer hold the eyelid up.

Causes

Blepharochalasis is idiopathic in most cases, i.e., the cause is unknown. Systemic conditions linked to blepharochalasis are renal agenesis, vertebral abnormalities, and congenital heart disease.

Epidemiology

It is encountered more commonly in younger rather than older individuals.

Complications

Complications of blepharochalasis may include conjunctival hyperemia (excessive blood flow through the moist tissues of the orbit), chemosis, entropion, ectropion, and ptosis.

Differential diagnosis

Dermatochalasis is sometimes confused with blepharochalasis, but these are two different conditions.

Treatment/Surgery

A surgeon trained to do eyelid surgery, such as a plastic surgeon or ophthalmologist, is required to decide and perform the appropriate surgical procedure. The following procedures have been described for blepharochalasis:

• External levator aponeurosis tuck
• Blepharoplasty
• Lateral canthoplasty
• Dermis fat grafts

These are used to correct atrophic blepharochalasis after the syndrome has run its course.

References

External links

• Review of Optometry handbook article on Blepharochalasis
• Picture of patient with Blepharochalasis
• BJO article abstract on Blepharochalasis