An unusual case of blepharochalasis

Purpose: to describe a rare case of blepharochalasis that progressed from unilateral to bilateral involvement at five years after disease onset. case report: a previously healthy five-year-old white boy presented to our hospital for a screening visual examination. he was found to have a 2-mm right eyelid ptosis with crepe-like skin and subcutaneous telangiectatic vessels. his mother noted that since the age of three,the child has been having two to seven day-long episodes of right upper eyelid swelling and edema with tenderness. the episodes eventually progressed to involving the left eyelid as well. oral steroid taper was found to effectively resolve these exacerbations,and a diagnosis of blepharochalasis was made. conclusion: blepharochalasis should be in the differential diagnosis for young children presenting with unilateral or bilateral ptosis with periorbital skin abnormalities. dworak douglas 1 department of surgery,john h. stroger,jr. hospital of cook county division of ophthalmology,chicago,il patel shyam 2 department of surgery,john h. stroger,jr. hospital of cook county division of ophthalmology,chicago,il thompson lisa 3 department of surgery,john h. stroger,jr. hospital of cook county division of ophthalmology,chicago; department of surgery,medical eye services,il bergin dj,mccord cd,berger t,friedberg h,waterhouse w. blepharochalasis. br j ophthalmol 1988;72:863-867. koursh dm,modjtahedi sp,selva d,leibovitch i. the blepharochalasis syndrome. surv ophthalmol 2009;54:235-244. custer pl,tenzel rr,kowalczyk ap. blepharochalasis syndrome. am j ophthalmol 1985;99:424-428. goldberg r,seiff s,mcfarland j,simons k,shorr n. floppy eyelid syndrome and blepharochalasis. am j ophthalmol 1986;102:376-381. hallahan km,sood a,singh ad. acute episode of eyelid oedema. br j ophthalmol 2012;96:909-913. collin jr. blepharochalasis. a review of 30 cases. ophthal plast reconstr surg 1991;7:153-157. mercy p,ghorpade a,das m,soud a,agrawal s,kumar a. blepharochalasis. indian j dermatol venereol leprol 2009;75:197-199. grassegger a,romani n,fritsch p,smolle j,hintner h. immunoglobulin a (iga) deposits in lesional skin of a patient with blepharochalasis. br j dermatol 1996;135:791-795. iovieno a,lambiase a,micera a,stampachiacchiere b,sgrulletta r,bonini s. in vivo characterization of doxycycline effects on tear metalloproteinases in patients with chronic blepharitis. eur j ophthalmol 2009;19:708-716. karaconji t,skippen b,di girolamo n,taylor sf,francis ic,coroneo mt. doxycycline for treatment of blepharochalasis via inhibition of matrix metalloproteinases. ophthal plast reconstr surg 2012;28:e76-e78. jacob m. idiopathic orbital inflammatory syndrome. oman j ophthalmol 2012;5:124-125. takahashi y,zheng x,mito h,noma k,kakizaki h. recurrent ptosis in a patient with blepharochalasis: clinical and histopathologic findings. j craniofac surg 2015;26:52-53. © 2017 journal of ophthalmic and vision research published by wolters kluwer - medknow.