Dermatochalasis

Gravity loss of elastic tissue in the skin and weakening of connective tissues in the eyelid frequently contribute to this sagging eyelid tissue. Excess and droopy eyelid skin and muscle is known as dermatochalasis. It is a common finding seen in elderly persons and it occurs evenly in both men and women. Gravity loss of elastic tissue in the skin and weakening of connective tissues in the eyelid frequently contribute to this sagging eyelid tissue. It is usually found in the upper eyelids but can be seen in the lower eyelids as well.

Causes & Effects The most common cause of dermatochalasis is the normal aging phenomenon. This includes loss of elastic fibres and thinning of the skin. Genetics may play a role in some patients who develop dermatochalasis and these patients frequently develop early signs in their 20s.

Dermatochalasis can be a functional or cosmetic problem. When functional dermatochalasis frequently obstructs the superior visual field (the upper part). Patients often note a fullness or heaviness of the upper eyelids bags in the lower eyelids and wrinkles. Some other symptoms and signs include difficulty driving and reading headaches from attempting to keep the eyelids up and dry eye.

Dermatochalasis is very common among elderly people yet the severity is variable. The age of onset is most frequently noted in the 40s and progresses with age. Besides cosmetic concerns visual field loss is the most frequent side effect of dermatochalasis. In severe cases patients can lose more than half of their superior visual field. Patients with a purely physical deformity may not have any visual field defects.

Treatment

Eyelid surgery (blepharoplasty) is the primary treatment for those whose vision is impaired or for those looking for cosmetic improvement. This surgery involves tightening the loose tissue around the eyes by removing excess skin and fat around the lids. Surgery is usually performed on an outpatient basis under local anaesthetic and it takes less than an hour. After surgery ice compresses are applied to lessen swelling. Over-the-counter pain medication such as aspirin acetaminophen (Tylenol) or ibuprofen (Advil) can reduce any discomfort you might have. Patients vary in their response to surgery but generally the swelling is gone within about two weeks. The scarring after surgery is usually minimal since these tissues tend to heal very well.

Most patients are delighted with their improved appearance and their unobstructed vision. As with any other type of surgery there is always risk. Make sure you contact your eye care practitioner to see if this is the right surgery for you.