Blepharochalasis

Overview
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. It typically affects only the upper eyelids, and may be unilateral as well as bilateral.

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- 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
An oculoplastic surgeon is required to decide and perform the appropriate surgical procedure. Following procedures have been described for blepharochalasis: They are used to correct atrophic blepharochalasis after the syndrome had run its course.
 * External levator aponeurosis tuck
 * Blepharoplasty
 * Lateral canthoplasty
 * Dermis fat grafts