What Is Dermatochalasis?
Dermatochalasis is a term used to describe sagging skin in the eyelids. There may be excess skin, as well as skin that has lost its elasticity. The eyelid also looses its connection to the tendons and muscles that control the lids. You may also notice that you have “lost” the crease in your eyelids, as the excess skin folds over itself and in some cases, covers the eyelashes.
Most often, dermatochalasis occurs in both eyes, as well as in both the upper and lower lids, although it may be less apparent in the lower lid.
Dermatochalasis normally occurs as a result of aging. As with other tissue in our bodies, as we age, our skin becomes thinner and looses elasticity. As the skin in our eyelid looses its elasticity, it usually presents a cosmetic problem and not a vision problem.
If you have dermatochalasis, you may be continually using your forehead muscles to keep your eyes open and to see clearly. You may not even be aware that you are doing so. While your vision isn’t being directly affected, you may experience headaches from using these muscles excessively. The headaches and associated fatigue may prompt you to see your doctor or eye doctor, particularly if you associate the symptoms with reading or other close work.
While dermatochalasis itself rarely causes vision problems, many people with dermatochalasis also concurrently have ptosis, a droopy upper eyelid caused by a weakness in the muscles or the nerves that control the eyelid. In severe cases of ptosis, the lid can almost completely cover your pupil. In such cases, your vision will likely be affected and you may notice that you tilt your head backwards to see more clearly.
How Is Dermatochalasis Detected?
Dermatochalasis is detected by a visual inspection of your eye and eyelid. This will be done as part of a comprehensive eye exam that will also include:
- Dilated eye exam / slit lamp examination: A comprehensive examination of your eye and retina
- Tonometry: Measuring your intraocular pressure
- Ophthalmoscopy: Evaluating any optic nerve or retinal disorder
- Visual acuity and refraction: Testing your vision in each eye and identifying any refractive error
- Visual field testing may be performed to assess loss of visual field due to eyelid malposition obscuring the field of vision, especially superiorly.
It is important that your ophthalmologist have a complete understanding of the overall health of your eyes and your vision.
How Is Dermatochalasis Treated?
Although dermatochalasis does not impact your central vision, it can cause loss of peripheral or side vision, especially superior (upper) vision. The excess skin can be removed in a minor outpatient procedure called blepharoplasty, the medical term for eyelid surgery. Our board certified ophthalmologist who has also done a fellowship in oculoplastic surgery performs this surgical treatment for dermatochalasis to achieve the best acceptable cosmetic and functional result. He will review the appropriate treatment options with you.
During this procedure, you will feel little or no discomfort. On the day of treatment, a staff member will welcome you.The staff will help you prepare for your surgery by putting eye drops in your eye. You will be given a gown to wear over your street clothes during your actual surgery.
You may be given a relaxing sedative along with local anesthetic. An injection will also be given around the eye for comfort. Usually self-dissolving stitches will be used to close the incision. In most cases, no eye patch is used.
Immediately after the surgery, you will rest in a comfortable reclining chair. Your family members may then join you in reviewing your follow-up care and schedule. You may be given medication or eyedrops to prevent infection.
Your eye may appear to be slightly bruised and swollen following the surgery. However, this should not cause significant discomfort. Your surgeon will follow-up with you to monitor healing, and check for signs of inflammation and infection.
Some potential complications from surgery include the risk of bleeding, infection and hematoma, which can usually be successfully treated. In addition, a small number of patients may have temporary or permanent difficulty in fully closing their lids when they sleep. In such cases, special ointments or drops may be used to maintain lubrication in the eye. Most patients who are dissatisfied with the impact of dermatochalasis upon their appearance believe the functional and cosmetic benefits outweigh these risks.
Oculoplastic Specialist at Kadrmas Eye Care New England
Meet our oculoplastic surgeon who specializes in the treatment of eyelid diseases and disorders: