Mechanical: Dermatochalasis

A 75-year-old woman complained of"tired and heavy eyes" and being unableto keep her eyelids open to readat night.

Redundant upper eyelid tissuethat weighed down the patient's eyelidsand temporal hooding were found (A).There was also a mild involutional ptosisof both upper eyelids.

This patient has dermatochalasis-a bilateral condition commonlyseen in elderly persons. It results frommany years of stretching the tissue byblinking, rubbing the eyes, and enduringgravitational forces. The conditionalso may be associated with weaknessof the orbital septum and secondaryanterior displacement of orbital fat.

This patient underwent a bilateralupper eyelid blepharoplasty to correctthe problem. After the first postoperativeweek, edema and ecchymosis werestill present (B). At the 1-month followup,slight involutional ptosis was stillevident, but the patient no longer hadsubjective complaints (C).