Dermatochalasis
The medical term for excess eyelid skin that impairs vision is dermatochalasis. 1, 2, 3
Definition and Clinical Characteristics
Dermatochalasis is characterized by lax, redundant, and overhanging excess eyelid skin that develops as part of the normal aging process of the eyelids. 1 This condition affects the upper eyelids most commonly and can produce both cosmetic defects and functional impairment. 3
Functional Impact
When dermatochalasis is severe enough, it blocks the peripheral visual field and causes asthenopic symptoms (eye strain and discomfort). 3 The excess skin literally hangs over the eyelid margin and obstructs the superior visual field, creating a functional visual impairment rather than just a cosmetic concern.
Distinction from Blepharochalasis
It is important to distinguish dermatochalasis from blepharochalasis, which is a different condition:
- Dermatochalasis: Age-related excess skin without underlying fat or structural changes 3
- Blepharochalasis: An uncommon disorder characterized by recurrent episodes of eyelid edema in young patients, leading to fat herniation or atrophy, ptosis, and eventual redundant skin with fine wrinkling, atrophy, and telangiectasias 4
Treatment Approach
Surgical blepharoplasty is the gold standard treatment for dermatochalasis causing visual field obstruction. 2 For dermatochalasis specifically, the procedure removes excess skin only, whereas blepharochalasis surgery may require additional interventions including fat removal, orbital septum tightening, and correction of associated ptosis. 3, 4
Alternative Non-Surgical Options
For patients who are not surgical candidates or prefer non-invasive approaches, ablative radiofrequency microplasma technology has shown efficacy in treating moderate to severe upper eyelid dermatochalasis, with 41% of patients showing 2-grade improvement and 59% showing 1-grade improvement on a 4-point scale. 1