From the Research
Blepharochalasis should be managed with a combination of medical and surgical approaches, prioritizing surgical correction through blepharoplasty after a quiescent period of at least 2 years, as evidenced by the most recent and highest quality study 1.
Overview of Blepharochalasis
Blepharochalasis is a rare eyelid disorder characterized by recurrent episodes of painless edema of the upper and occasionally lower eyelids, leading to atrophic, wrinkled, and discolored periorbital skin, as well as other clinical manifestations such as ptosis, acquired forms of blepharophimosis, and prolapse of orbital fat 2.
Clinical Characteristics and Diagnosis
The condition often presents in childhood or early adolescence, with the mean age of onset being around 10 years, and stabilizes until adolescence 1, 3. The clinical features of blepharochalasis include recurrent episodes of eyelid swelling, thinning, stretching, and sagging of the eyelid skin, and various periorbital deformities such as ptosis, lacrimal gland prolapse, and lower eyelid retraction 4, 1, 3.
Treatment Options
Treatment typically involves managing acute episodes with cold compresses and sometimes oral antihistamines like diphenhydramine (25-50mg) or cetirizine (10mg) daily during flare-ups, as well as a short course of oral prednisone (20-40mg daily for 5-7 days) for severe inflammation [@Example@]. However, the most effective approach is surgical correction through blepharoplasty, which should be performed after a quiescent period of at least 2 years to minimize the risk of overcorrection and recurrence 1, 3.
Surgical Management
Surgical management of blepharochalasis and its associated deformities in the quiescent stage is usually safe and has satisfactory cosmetic effects, with functional and cosmetically acceptable results achieved in most patients 1, 3. The surgical approach may include blepharoplasty, resuspension of the prolapsed lacrimal gland, ptosis repair, surgical correction of lower eyelid retraction, and lateral canthoplasty 3.
Prognosis and Outcomes
The prognosis of blepharochalasis is generally good, with most patients achieving functional and cosmetically acceptable results after surgical correction 1, 3. However, patients should be aware that multiple surgeries might be necessary if the condition remains active, as operating during active inflammation can worsen outcomes [@Example@].