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An Unusual Case of Blepharochalasis
Douglas P Dworak1, Shyam A Patel1, Lisa S Thompson1,2
1Department of Surgery, John H. Stroger, Jr. Hospital of Cook County Division of Ophthalmology, Chicago, IL, USA.
Insights
This case study highlights blepharochalasis, a rare condition causing eyelid swelling and ptosis in children. It details its progression from one eye to both, emphasizing early diagnosis for effective management.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Dermatology
Background:
- Blepharochalasis is a rare condition characterized by recurrent eyelid swelling.
- It typically affects young adults but can occur in children.
- Early diagnosis and management are crucial for preventing complications.
Observation:
- A five-year-old boy presented with unilateral ptosis, crepe-like eyelid skin, and telangiectatic vessels.
- He experienced recurrent episodes of eyelid swelling and edema since age three.
- The condition later progressed to bilateral involvement.
Findings:
- The patient's symptoms responded well to oral steroid taper.
- A diagnosis of blepharochalasis was confirmed.
- The case illustrates the potential for blepharochalasis to progress from unilateral to bilateral presentation.
Implications:
- Blepharochalasis should be considered in the differential diagnosis of pediatric ptosis.
- Recognizing periorbital skin abnormalities alongside ptosis is key.
- Prompt diagnosis can lead to timely intervention and improved outcomes for affected children.
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.
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