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Blepharochalasis: ‘drooping eyelids that raised our eyebrows’
  1. Muhammed Razmi T1,
  2. Aastha Takkar2,
  3. Debajyoti Chatterjee3,
  4. Dipankar De1
  1. 1Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  3. 3Department of Histopathology, Government Medical College and Hospital (GMCH), Chandigarh, India
  1. Correspondence to Dr Dipankar De, Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India; dr_dipankar_de{at}yahoo.in

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A 20-year-old woman presented with drooping of both the eyelids (left>right). She had intermittent upper eyelid oedema for 3 years. There was no diurnal variation or fatiguability. The neuro-ophthalmic examination was normal including the extraocular movements. Serum anti-acetylcholine receptor antibodies, CT of the orbit and electromyography were unremarkable. Loose overhanging skin changes were highlighted on clinical reassessment (figure 1A). Atrophy of nasal fat pad causing ‘pseudo-epicanthic fold’ was noted (figure 1B). A diagnosis of blepharochalasis was confirmed on histopathology by demonstrating markedly reduced elastic fibres in the dermis (figure 2). Oral doxycycline (200 mg/day) in combination with topical tacrolimus 0.1% gel was given for 3 months with partial improvement. She disregarded a future plan of blepharoplasty.

Figure 1

Clinical presentation of blepharochalasis. …

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