Clinical Experiences in Blepharochalasis Syndrome

Purpose: To report the clinical manifestations and experiences in blepharochalasis syndrome. Methods: We performed a retrospective, noncomparative chart review on six patients with blepharochalasis syndrome who were followed up at our hospital from 2004 to 2009. The demographics, clinical features, associated factors, clinical courses, differential diagnosis, treatment and histopathological results were discussed. Results: Six patients (5 women, 1 man) with an average presenting age of 16 (range, 10-23 years) had blepharochalasis syndrome. The attack duration averaged 2 days, but the recurrent episodes of eyelid edema sometimes lasted for years. The attack frequency was associated with the stage of the disease and the age of the patients. All patients had upper lid involvement, and lower lid involvement were only found in severe cases. Four patients had unilateral eyelid edema, and the other two had bilateral eyelid edema. Five of the patients received levator aponeurosis advancement surgery, and the postoperative results were satisfactory. Conclusion: We presented our clinical experiences in blepharochalasis syndrome in Taiwan. Because it is easily misdiagnosed as allergic angioedema in the acute stage, recurrent edema beginning in adolescence and a poor response to antihistamines may help to make a differential diagnosis. We should consider the possibility of this rare syndrome when diagnosing young patients having unusual acquired ptosis, with redundant, thinning, atrophic, and stretched eyelid skin.