Blepharochalasis is a term used to define the 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 resulting in redundant folds over the lid margins. Blepharochalasis typically affect the upper eyelids, and may be unilateral as well as bilateral. Blepharochalasis results from recurrent bouts of painless eyelid swelling, each last for several days.This condition is thought to be one of the form of localized angiodema or rapid accumulation of fluid in the tissues. Consequent episodes of attack lead to thinning and atrophy of skin of eyelids.Damage to the levator palpebrae superioris muscle causes ptosis or drooping of the eyelid when the muscle can no longer hold the eyelid up.Age/sex prevalence of Blepharochalasis
Blepharochalasis is more commonly seen in younger individuals rather than older ones. Males and females both are affected.
Individuals of any race can be affected.
The definite cause is unknown but there are few factors that can lead to the development of blepharochalasis and are as follows – Systemic conditions linked to blepharochalasis are as follows
• Renal agenesis
• Vertebral abnormalities
• Congenital heart disease There are other factors which can also lead to blepharochalasis are as follows
• Hormonal factor
• Genetic factor
In the active phase of disease characterize the atrophic phase of blepharochalasis. These sequel include the following:
• First occur severe thinning of eyelid skin
• Fine wrinkling of the skin of eyelid
• Stretched, redundant eyelid skin, occasionally causing visual obstruction
• Subcutaneous telangiectasia
• Upper blepharoptosis with levator aponeurosis dehiscence
• Eyelid malposition in two forms ectropion or entropion
• Acquired blepharophimosis due to canthhal tendon dehiscence
• Orbital fat prolapse
• Lacrimal gland prolapsed.
Physical examination is the first step in the investigation of blepharochalasis. Imaging studies helping are as follows –
• CT scanning
• MRI In the last step hiostological findings are done by taking biopsy sample of the part affected.
Treatment for blepharochlasis include the following procedures-
• Lateral canthoplasty
• Dermis fat grafts
• External levator aponeurosis tuck
• Conjuctival hyperemia
Differential diagnosis of blepharochalasis is as follows:-
• Hereditary angioedema
• Orbital cellulitis
• Cavernous sinus thrombosis
• Localized cutis laxa
• Contact dermatitis
• Thyroid-associated ophthalmopathy
• Idiopathic orbital inflammation
• Lacrimal gland tumor
• Floppy eyelid syndrome
• Orbital hemangioma
As the age of individual increases the frequency of attacks of swelling subsides. After an episode period of inactivity the unexpected episodes may occur.