Year : 1961 | Volume
: 9 | Issue : 2 | Page : 37--38
Gandhi Eye Hospital and M.U. Inst. of Ophthalmology, Aligarh, India
Gandhi Eye Hospital and M.U. Inst. of Ophthalmology, Aligarh
|How to cite this article:|
Dayal Y. Blepharochalasis.Indian J Ophthalmol 1961;9:37-38
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Dayal Y. Blepharochalasis. Indian J Ophthalmol [serial online] 1961 [cited 2020 Sep 19 ];9:37-38
Available from: http://www.ijo.in/text.asp?1961/9/2/37/39683
This unusual disease, a juvenile atrophic anomaly of lids, though not rare, is still quite uncommon. It is characterized by atrophy and relaxation of the tissues of the upper lids following chronic or recurrent oedema of the anterior structures of the orbit (Duke-Elder, 1952). Though first mentioned by Beer (1807), it was properly described by Fuchs (1896) who designated it Blepharochalasis. Later other names like ptosis atrophica (Weinstein, 1909), and acrodermatitis chronica progressiva (Schreiber, 1921) have also been suggested.
First case, (Photo 1)
A young healthy boy, N. K., aged 14 years attended the hospital with a history of intermittent swellings of both upper lids for the last 2 years. Succeeding attacks of swelling became more frequent lately, leading to permanent bagginess of the upper lids. His parents, brothers and sisters were healthy with no evidence of any such ocular affection.
Examination revealed swelling of upper lids with presence of loose folds over the lid margins, significantly seen on the right side. The skin appeared slightly discoloured, thin and flabby. No other ocular pathology could be detected. Visual acuity in both the eyes was 6/6.
General examination revealed no abnormal finding of skin anywhere else or systemically. Blood and urine examinations were normal.
A young girl S. K., aged 17 years attended the hospital with the complaint of puffiness of the upper lids for the last 4 years. She told that there had been transient attacks lasting 2 to 3 days during which the upper lids got slightly reddened and swollen. There was no history of pain. However some occasional watering and itching was complained of. For the last one year frequency had increased and now she felt a permanent bagginess of the skin of the upper lids covering partly the lid margins. There was no history of any such ocular illness in the family, within the knowledge of her parents.
On examination, the upper lids were found swollen, right more than left without any inflammatory sign. The skin was thin and quite loose. Power to lift the lid was felt to be decreased in the right eye. Other ocular structures were normal. Visual acuity was: R.E. 6/9p, with-o.75 cyl. axis 10° 6/6; L.E. 6/9, with-0.50 cyl. axis 180◦ 6/6.
General examination did not disclose any pathological change in any other area of skin in the body or in any of the systems. Blood and urine examination revealed normal findings.
The aetiology of this condition is not known. Some vague factors like endocrine disorders, endogenous toxins or some vasomotor or trophoneurotic factors are mentioned as the possible aetiologic agents (Duke Elder, 1952), but none of them could be proved for certain in most of the cases reported ii, the literature so far. Pathologically the main change is a general atrophy of all the layers of the skin with loss of elastic tissue. Proliferation of the capillary endothelium together with a round-celled infiltration may often be seen, and this may suggest the possibility of a chronic low-grade inflammation (Fuchs, 1896; Friendenwald, 1923). All this confirms that the actual cause still remains obscure and that there is yet a great scope for speculation. In the presence of an obscure aetiology, there is no cure of the condition. Only a cosmetic relief may be provided by surgery in advanced cases.
Two cases of blepharochalasis, one of either sex with no hereditary transmission, are presented . Vague aetiology of the condition is stressed.
|1||Duke-Elder, S. 1952, Text-Book of Ophthalmology, Vol. V, p. 5001-5003, Kimpton, London.|