Blepharochalasis is an inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

 of the eyelid
An eyelid is a thin fold of skin that covers and protects an eye. With the exception of the prepuce and the labia minora, it has the thinnest skin of the whole body. The levator palpebrae superioris muscle retracts the eyelid to "open" the eye. This can be either voluntarily or involuntarily...

 that is characterized by exacerbations and remissions of eyelid edema
Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...

, which results in a stretching and subsequent atrophy
Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations , poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, disuse or lack of exercise or disease intrinsic to the tissue itself...

 of the eyelid tissue resulting in redundant folds over the lid margins. It typically affects only the upper eyelids, and may be unilateral as well as bilateral.


Blepharochalasis results from recurrent bouts of painless eyelid swelling, each lasting for several days. This is thought to be a form of localized angioedema
Angioedema or Quincke's edema is the rapid swelling of the dermis, subcutaneous tissue, mucosa and submucosal tissues. It is very similar to urticaria, but urticaria, commonly known as hives, occurs in the upper dermis...

, or rapid accumulation of fluid in the tissues. Recurrent episodes lead to thin and atrophic skin. Damage to the levator palpebrae superioris muscle
Levator palpebrae superioris muscle
The levator palpebrae superioris is the muscle in the orbit that elevates the superior eyelid.-Structure:...

 causes ptosis
Ptosis (eyelid)
Ptosis is a drooping of the upper or lower eyelid. The drooping may be worse after being awake longer, when the individual's muscles are tired. This condition is sometimes called "lazy eye", but that term normally refers to amblyopia...

, or drooping of the eyelid, when the muscle can no longer hold the eyelid up.


Blepharochalasis is idiopathic in most cases, i.e., the cause is unknown. Systemic conditions linked to blepharochalasis are renal agenesis
Renal agenesis
Renal agenesis is a unilateral or bilateral medical condition in which one or both fetal kidneys fail to develop leading to oligohydramnios, resulting in a 40-fold increase in perinatal mortality.It can be associated with RET or UPK3A.-Bilateral:...

, vertebral abnormalities, and congenital heart disease.


Complications of blepharochalasis may include conjunctiva
The conjunctiva covers the sclera and lines the inside of the eyelids. It is composed of rare stratified columnar epithelium.-Function:...

l hyperemia
Hyperaemia or hyperemia describes the increase of blood flow to different tissues in the body. It can have medical implications, but is also a regulatory response, allowing change in blood supply to different tissues through vasodilation. Clinically, hyperaemia in tissues manifest as erythema,...

 (excessive blood flow through the moist tissues of the orbit), chemosis
Chemosis is the swelling of the conjunctiva. In general, chemosis is a nonspecific sign of eye irritation. The outer surface covering appears to have fluid in it. Often, the eye area swells so much that the eyes become difficult or impossible to close fully. It is usually caused by allergies or...

, entropion
Entropion is a medical condition in which the eyelid folds inward. It is very uncomfortable, as the eyelashes constantly rub against the cornea. Entropion is usually caused by genetic factors and may be congenital...

, ectropion
Ectropion is a medical condition in which the lower eyelid turns outwards. It is one of the notable aspects of newborns exhibiting congenital Harlequin type ichthyosis, but ectropion can occur due to any weakening of tissue of the lower eyelid. The condition can be repaired surgically...

, and ptosis.

Differential diagnosis

Dermatochalasis is a medical condition. It is defined as an excess of skin in the upper or lower eyelid. It may be either an acquired or a congenital condition. It is generally treated with blepharoplasty....

 is sometimes confused with blepharochalasis, but these are two different conditions.


A surgeon trained to do eyelid surgery, such as a plastic surgeon or ophthalmologist, is required to decide and perform the appropriate surgical procedure. Following procedures have been described for blepharochalasis:
  • External levator aponeurosis tuck
  • Blepharoplasty
    Blepharoplasty is surgical modification of the eyelid. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery.-Indications:...

  • Lateral canthoplasty
    Canthus (anatomy)
    Canthus is either corner of the eye where the upper and lower eyelids meet. More specifically, the medial and lateral canthi would be described as the medial and lateral ends/angles of the palpebral fissure....

  • Dermis fat grafts

These are used to correct atrophic blepharochalasis after the syndrome has run its course.

External links

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