An unusual case of blepharochalasis

Abstract

Purpose:To describe a rare case of blepharochalasis that progressed from unilateral to bilateral involvement at five years after disease onset.Case Report:A previously healthy five-year-old white boy presented to our hospital for a screening visual examination. He was found to have a 2-mm right eyelid ptosis with crepe-like skin and subcutaneous telangiectatic vessels. His mother noted that since the age of three, the child has been having two to seven day-long episodes of right upper eyelid swelling and edema with tenderness. The episodes eventually progressed to involving the left eyelid as well. Oral steroid taper was found to effectively resolve these exacerbations, and a diagnosis of blepharochalasis was made.Conclusion:Blepharochalasis should be in the differential diagnosis for young children presenting with unilateral or bilateral ptosis with periorbital skin abnormalities.

Stepwise surgery with variable adjustments for severe blepharochalasis with multiple chemical sensitivity: a case report

“…Treatment of blepharochalasis involves correcting the aponeurotic ptosis and resecting the redundant palpebral skin [11], and surgery should be performed during the quiescent phase [11][12][13]. Since surgical overcorrection is frequently associated with complications, Koursh et al [1] and Bergin et al [12] have advocated intentional undercorrection.…”

Blepharochalasis at early age: A case report

“…Until 2009 only 67 cases had been reported. It is characterized by recurrent episodes of painless and nonpruritic eyelid edema that begins in childhood and ends up producing atrophy and periocular skin depigmentation, tissue relaxation and ptosis in adult age [1][2][3]. Other manifestations include lower eyelid retraction, pseudo-epicanthal folds, and fat prolapse of orbital and lacrimal gland [2].…”

“…This condition can be bilateral or unilateral, the latter being less frequent and of later onset [3]. Only one case has been reported of a patient with both, unilateral and bilateral outbreaks [1]. Episodes last between hours and days, becoming less frequent as the years go by.…”

“…The diagnosis of blepharochalasis is clinical. Image tests are unnecessary, as they do not demonstrate anomalous results, and palpebral biopsy does not demonstrate specific results, frequently showing elastic fibers decrease as the episodes progress [1,2]. Regarding pharmacological treatment, there is poor response to oral or local antihistamines and cortisone [5].…”

“…Once ptosis and dermatochalasis appear the only effective treatment is surgery. A quiescent period of 6 months to 2 years is recommended before any intervention is performed [1,4,6,7].…”