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Topical prostaglandin analogs can cause orbital soft-tissue changes, including eyelid thinning and malposition. These prostaglandin-induced orbitopathy effects may lead to cosmetic and functional eyelid disorders.

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Area of Science:

  • Ophthalmology
  • Oculoplastics
  • Dermatology

Background:

  • Topical prostaglandin analogs are widely used for glaucoma management.
  • While generally well-tolerated, these medications can induce orbital soft-tissue changes.

Purpose of the Study:

  • To document the spectrum of orbital soft-tissue alterations associated with topical prostaglandin analog use.
  • To identify functional and cosmetic eyelid disorders resulting from these changes.

Main Methods:

  • A case series design was employed.
  • Patients evaluated in a referral oculoplastic practice with suspected prostaglandin orbitopathy were included.

Main Results:

  • Thirty-five patients exhibited various changes: superior sulcus deepening (24/35), hypertrichosis (32/35), periocular erythema (24/35), and meibomian gland dysfunction (18/35).
  • Common findings included marginal eyelid thinning with posterior lash migration (34/35) and increased eyelid tension with horizontal shortening (32/35), often linked to lateral canthal deformity (15/35).
  • Functional issues comprised tractional ptosis, cicatricial entropion/ectropion, trichiasis, eyelid subluxation, and chalazia.

Conclusions:

  • Topical prostaglandin analogs can cause structural orbital soft-tissue changes, leading to cosmetic and functional eyelid disorders.
  • Eyelid margin thinning, posterior lash migration, and acquired blepharophimosis are potential consequences.
  • These orbital changes may be partially reversible; withholding medication and observation before surgery is recommended.