Although blepharochalasis is not an involutional change, it is included in this discussion because it can resemble, and must be differentiated from, dermatochalasis. Blepharochalasis is a rare familial variant of angioneurotic edema. It occurs most commonly in young females and is characterized by idiopathic episodes of inflammatory edema of the eyelids. As a result of recurrent bouts of inflammation and edema, the eyelid skin becomes thin and wrinkled, simulating the appearance of dermatochalasis. In addition, true ptosis, herniation of the orbital lobe of the lacrimal gland, atrophy of the orbital fat pads, and prominent eyelid vascularity may be associated with blepharochalasis. Surgical repair of the eyelid skin changes and ptosis associated with blepharochalasis may be complicated by repeated episodes of inflammation and edema.
Koursh DM, Modjtahedi SP, Selva D, Leibovitch I. The blepharochalasis syndrome. Surv Ophthalmol. 2009;54(2):235–244.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.