Blepharhalasis

A condition in which the skin of the upper eyelids hangs in the form of a sac over the edge of the eyelid is blepharohalasis. Consider the main causes of this pathology and treatment methods.

Bilateral atrophy of the skin of the upper eyelids is a pathological process caused by damage to the elastic fibers of the connective tissue and characterized by increased flabbiness of the epidermis. According to the International Classification of Diseases of the 10th revision of ICD-10, blepharohalasis is included in this category VII Diseases of the eye and its adnexa (H00-H59):

H00-H06 Diseases of the eyelid, lacrimal system and orbit.

• H02 Other diseases of the eyelids.
  • H02.3 Blepharhalasia (dermatolysis).

Hypertrophy of the tissues of the upper eyelid is usually formed under the influence of individual features of the structure of the skin, with age-related changes or prolonged swelling of the eyelids. As a rule, this disease is diagnosed in people in old age.

Many doctors claim that the atrophy of the eyelids is associated with endocrine, vascular or neurotrophic disorders. In some cases, the disorder manifests itself in hereditary pathology - the syndrome of premature aging of the skin "cutis laxa". For the treatment of inflammatory eyelid edema it is necessary to consult an ophthalmologist and a plastic surgeon.

[1], [2], [3], [4], [5], [6], [7]

Epidemiology

Blepharhalasia has an age dependence. Statistics indicate that the pathologies of the eyelids occupy about 10% of the total structure of ophthalmic diseases. This is due to the fact that the eyelids consist of different tissues, which react differently to the same irritation. That is why the diseases of the eyelids are classified by anatomical sign, and not by etiopathogenetic.

According to medical statistics, an increase in the number of upper eyelid tissues is most often diagnosed in patients with hereditary predisposition and neglected endocrine diseases.

[8], [9], [10], [11], [12]

Causes of the blepharohalasis

To date, reliable causes of blepharohalasis have not been established. The disease has an idiopathic origin. Among the possible reasons are the following:

• Endocrine disorders and diseases.
• Pathology of the vascular system.
• Hereditary predisposition.
• Neutrophication disorders.
• Inflammatory diseases of the eyelids.
• Allergic reactions.
• Vasomotor disorders.
• Asher's Syndrome.
• Progressive atrophy of the skin.

Regardless of the cause, the treatment of the disorder is performed only surgically.

[13], [14]

Risk factors

Since the atrophy of the eyelids has an idiopathic origin, there are a number of risk factors that can provoke it. First of all, it is violations of the endocrine system and genetic factors. Sporadic variants of the pathology development are also singled out:

• Inflammation of the eyelids.
• Allergic reactions.
• Thyroid dysfunction.
• Vasomotor disorders.

There is an assumption that dermatolysis is associated with progressive skin atrophy. In some cases, atrophy manifests simultaneously with the string and the double lip, which indicates Asher's syndrome.

The peculiarity of the disorder is that it begins imperceptibly, sometimes after a chronic, often recurring inflammation. Gradually, the skin of the eyelids loses elasticity, becomes flabby, thin with translucent vessels and small folds, hanging over the upper parts of the eye and limiting the field of vision.

[15], [16], [17],

Pathogenesis

The mechanism of origin of blepharohalasis depends entirely on the cause that provoked it. Pathogenesis in most cases is associated with periodic inflammation of the upper eyelid. The inflammatory process is accompanied by puffiness. Frequent recurrences of edema lead to atrophy of the fibrous structures of the eyelid, which ensure its elasticity. As the disease progresses, the function of the muscles responsible for raising the eyelid is disrupted.

[18], [19], [20], [21], [22], [23], [24]

Symptoms of the blepharohalasis

Excess tissue of the upper eyelid has a number of characteristic features. Symptoms of blepharohalasis occur with the same frequency, both among men and women. In this case, most often in elderly patients. Single cases of the development of the disease during puberty were also recorded.

The main symptoms of pathology:

• Excessive growth of the tissues of the upper eyelid.
• Hanging of the skin fold on the upper lashes.
• Loss of elasticity of the skin and its increased stretch.
• Through the skin of the eyelid, enlarged blood vessels appear.

Tissue loosening is especially noticeable when viewed from the side. Every year, atrophy becomes more pronounced. Blepharochalasis can progress so much that the skin begins to hang over the upper lashes, closing the pupil and disturbing the vision.

[25], [26], [27], [28], [29]

First signs

According to the conducted studies, it is established that the disease can have an inconspicuous beginning, and can manifest itself in the form of a chronic often recurrent inflammatory process on the eyelids. Because of permanent swelling, the skin becomes thinner and a bag is formed that hangs over the eyes.

Consider the first signs of hypertrophy of the tissues of the upper eyelid and their progression:

• Swelling / swelling of tissues.
• The formation of the skin fold, which is particularly noticeable at the sight of the side of the head and the movement of the facial musculature.
• Essential expansion of the circulatory system in the eyelid.
• Loss of elasticity, flabbiness and thinness of the skin.

As the disease progresses, the skin becomes more and more stretched, hanging over the eye and partially closing the vision.

[30], [31], [32], [33]

Blepharohalasis of lower eyelids

Such a pathology as blepharohalasis of lower eyelids is much less common than atrophy of upper tissues. The enlargement and dangling of the skin fold of the lower eyelid creates the impression of a bag under the eyes. Very often this type of pathology is confused with the turn of the century, when the ciliary edge does not belong to the eyeball, as it is turned outward. Because of this, the skin strongly hangs, opening the eyeball.

The disease can develop with inflammatory processes of the conjunctiva and the eyelid. Violation occurs when the facial nerve neuropathy. The origin of blepharohalasis may be due to a lack of firmness of the skin with the levator tendon, defects of the tarzorbital fascia or with thinning / overgrowth of the skin due to recurrent anginaurotic edema. Pathology delivers cosmetic inconveniences, so the treatment is based on surgical excision of excess skin fold.

[34], [35], [36], [37]

Stages

In its development, blepharohalasis passes through several stages. At the initial stage, the skin loses its elasticity and gradually becomes thinner. Most often this is associated with a recurrent inflammatory process. As the disease progresses, small blood vessels appear, which quickly become pronounced. At the last stage, the eyelid acquires a baggy form, covering part of the eye and disrupting sight.

[38], [39], [40]

Forms

Specific types of disorder do not exist. Single-sided and bilateral blepharohalasis is distinguished. The edema of the eyelids is also distinguished by the location of the skin fold: the upper eyelid or the lower one.

The following forms of dermatolysis are distinguished:

• Autosomal recessive - signs of the disease are expressed already at birth or develop rapidly as they grow older. Sluggish skin hangs down in large folds, but it is not atrophic and not hyperelastic. Sirloin folds give the person a whiny expression.
• Autosomal dominant (limited) - hypertrophy of the eyelids appears simultaneously with the syndrome of Asher. Progressive enlargement of the lips (often the upper one) occurs due to the edema of the mucosa and the formation of transverse furrows.

Atrophy can be associated with genetic and acquired factors.

[41], [42], [43]

Complications and consequences

The increase in the number of tissues of the upper eyelid tends to progress. The consequences and complications are manifested in the form of a pronounced cosmetic defect. To treat a pathological condition, surgical intervention is used. Blepharoplasty can lead to such problems:

• Retrobulbar hematoma - occurs due to bleeding in the postoperative period and blood accumulation in the cavity of the orbit. It is manifested by significant edema, increasing exophthalmos, sharp decrease in vision and restriction of mobility of the eyeball. To eliminate this complication, the wound is inspected, drained and blood clots removed.
• Suppuration of the postoperative wound - manifests itself in the form of infiltration of the skin of the upper eyelids, severe swelling and soreness. For treatment, antiseptic washings and drainage of the wound site are used.
• Hypertrophic scars - are formed due to disruption of normal scar development. Look like dense strands of red, which pull together thin tissue, forming skin folds. To eliminate this effect of surgery, prescribe miogimnastiku.
• Conjunctivitis (bacterial, viral, allergic) - occurs against a background of reduced local immunity after surgery, due to intolerance of medication or non-compliance with melted eyelids. It is manifested by the sensation of a foreign body in the eye, photophobia, itching, increased lacrimation. Treatment is local.
• Ptosis of the upper eyelid - most often due to a violation of the technique of surgery, that is, the trauma of the levator aponeurosis and subsequent scarring.
• Ectropion - this complication is associated with a violation of the supporting structures of the lower eyelid. Most often this is due to trauma of the pretasal part of the circular muscle of the eye.
• Enophthalmus - displacement of the eyeball posteriorly. It occurs because of excision of most of the orbital fat. The size of the eye gap decreases.
• Dark circles under the eyes - arise due to hyperinsolation in the postoperative period and the formation of a hematoma. Moderate hyperpigmentation occurs within 4 weeks after treatment. In other cases, bleaching agents with hydroquinone, glycolic acid and hydrocortisone are used.

Without proper treatment, hypertrophy leads to the fact that the skin folds begin to hang over the upper lashes, closing the field of view both from the side and from above. This leads to a visual impairment.

[44], [45], [46], [47], [48], [49], [50], [51], [52], [53]

Diagnostics of the blepharohalasis

Atrophy and enlargement of the upper eyelid skin refers to ophthalmic diseases. Diagnosis Blepharochalasis begins with a check of visual acuity and external examination of the eye. The ophthalmologist assesses the condition of the eyelids and conjunctiva, and if necessary conducts biomicroscopy.

In most cases, diagnosis is not difficult, because it is based on clinical manifestations of the disease. Blepharhalasis is characterized by saccular dangling of the skin fold above the eye, which can partially cover the pupil. Puffiness in most cases occurs as a recurrent inflammatory process.

[54], [55], [56], [57], [58], [59], [60]

Analyzes

A complex of laboratory studies in the diagnosis of blepharohalasis is carried out at all stages of the development of the disease and its treatment. Analyzes consist of:

• A general blood test is the first thing to pass. It gives information on the general state of the body: the content of cellular elements of blood (erythrocytes, leukocytes, lymphocytes, monocytes, etc.), hemoglobin level, hematocrit, erythrocyte sedimentation rate, color index.
• Blood on RW - this analysis is performed to identify the causative agent of syphilis or pale treponema. For the Wassermann reaction, venous blood is collected.
• Hbs antigen is a measure of the acute form of viral hepatitis B.
• Clotting time - there are several methods for conducting this analysis. But there is no uniform norm of coagulation. For example, according to Sukharev's technique, folding begins 30 seconds-2 minutes after the analysis begins and ends in 3-5 minutes. Minor deviations are variations in the norm.
• General urine analysis is a standard laboratory test used to diagnose almost all diseases. It allows to learn about the state of the cardiovascular system, immunity, kidneys and other internal organs and systems.

Based on the results of laboratory diagnosis, the doctor may prescribe additional studies or make a diagnosis.

[61], [62], [63], [64], [65]

Instrumental diagnostics

Atrophy of the skin of the upper or lower eyelids is a pathological condition that causes cosmetic discomfort and negatively affects visual acuity. Instrumental diagnostics for blepharohalasis consists of such procedures:

• Visual examination of the skin of the eyelids - the disease is characterized by atrophic changes, in which the tissues are thinned and stretched, small subcutaneous veins can be seen. The skin hangs folds at the outer corner of the eye, closing a review.
• Visometry is a test of visual acuity. Standard ophthalmological examination. To conduct it, use different metric tables with optotypes.
• Perimetry - diagnosis of the boundaries of the visual fields and their projection onto the spherical surface. It allows to detect visual field disturbances, and to determine the localization of the pathological process.

In addition to the above-described studies, gonioscopy, ocular examination, ultrasound, and various radiographic methods can be prescribed.

Differential diagnosis

In addition to laboratory and instrumental studies, blepharohalasis also shows differential diagnosis.

A differentiated diagnosis is made with such diseases:

• Angioedema angioedema - has a rapid onset, in contrast to dermatolysis, which develops gradually. On the background of puffiness of the eyelids painful sensations appear in the region of the lips, breathing is difficult. There may be allergic reactions from the skin, itching, rashes.
• Erysipelas is characterized by a sharp onset and a pronounced inflammatory process. The patient complains of a febrile state and a deterioration in overall well-being.
• Neurofibromatosis - except for the lesion of the eyelid region, areas with pathological changes occur throughout the body.
• Older atrophy of the skin of the eyelids - blepharohalasis develops at a young age and has a more pronounced atrophy.

In most cases, diagnosing pathology is not difficult, since the disorder has characteristic clinical manifestations.

Treatment of the blepharohalasis

Unfortunately, the treatment of blepharohalasis has not been developed to this day. To stop the progression of the pathological inflammatory process conservative methods are used, but their effectiveness is not great. The most effective method of therapy is surgical excision of excess skin.

All recommendations and the final decision about the operation are taken by an ophthalmologist and a plastic surgeon. In most cases, blepharoplasty is performed under local anesthesia. The operation lasts about 1.5-2 hours. In addition to removing the hypertrophy of the skin of the eyelids, lateral cantoplasty and an external lifting aponeurosis of the fold can be performed.

The recovery period lasts 1-2 weeks. The patient is prescribed various medications, vitamins and ointments that accelerate the process of recovery and minimize the risk of complications.

Medications

Medical treatment of blepharohalasis is performed immediately after the operation. Medicines are necessary to prevent infectious complications. To do this, use eye drops and ointments with antibiotic and antiseptic properties.

Most often, patients are prescribed such medicines:

1. Vitabakt is a broad spectrum antimicrobial agent. It has strong antiseptic properties. It is active against fungi, microbes, viruses. It is available in the form of a solution for instillation in the eye. The bottle-dropper contains 10 ml of 0.05% of the preparation. The active substance of drops is pyloxidine hydrochloride. Auxiliary components: polysorbate, anhydrous dextrose, purified water.

• Indications for use: prevention of postoperative complications in the anterior part of the eye, preoperative preparation, bacterial eye infections, dacryocystitis, inflammatory processes.
• Dosage and the way of application are determined by the attending physician, individually for each patient. When bacterial infections are instilled in 2 drops 2-6 times a day. As the inflammatory process decreases, the dosage is reduced. For the prevention of infection before surgery, once inoculated with 1-2 drops. The procedure is repeated the first day after the operation.
• Contraindications: individual intolerance to the components of the drug, pregnancy and lactation.
• Side effects: allergic reactions in the form of conjunctival hyperemia. It is also possible burning and redness. To eliminate these reactions, rinse eyes thoroughly with clean water and consult a doctor.

2. Diclof is a non-steroidal anti-inflammatory drug. It has analgesic, antipyretic and decongestant properties. Minimizes the manifestation of miosis during surgical manipulations.

• Indications for use: preoperative preparation, postoperative prophylaxis of inflammatory changes, treatment of posttraumatic processes on the eyeball, inflammatory changes in the conjunctiva.
• How to use: drops are used topically. Installations are carried out in a conjunctival sac. Dosage and duration of use depend on medical indications. Typically, the drug is used 1 drop every 6-8 hours. The average course of treatment takes 7-14 days.
• Side effects: in most cases, the drug is well tolerated. Very rarely develops corneal opacity, blurred vision, itching and redness of the eyelids, swelling of the face, urticaria, fever, vomiting.
• Contraindications: hypersensitivity to the drug components, intolerance to NSAIDs and acetylsalicylic acid, violations of hematopoiesis, gastrointestinal diseases with erosive or ulcerative defects. There have been no cases of overdose.

3. Indocollir is a local ophthalmic product with anti-inflammatory and analgesic properties. Contains the active ingredient - indomethacin from the NSAID group. Reduces the intensity of the inflammatory process, decreases the severity of the pain syndrome.

• Indications for use: treatment and prevention of inflammatory processes after surgery. Pain syndrome after photorefractive keratectomy. The drug is used 2-4 times a day for 1 drop in each eye.
• Side effects: hypersensitivity reactions, burning, pain in the eyes and hyperemia, temporary reduction in visual acuity, photosensitivity.
• Contraindications: individual intolerance of the drug components and NSAIDs. It is not prescribed for patients with an aspirin triad in anamnesis, with peptic ulcer, marked impairment of kidney and liver function. With special care is used before the planned operations before the eyes.
• Overdose: Frequent use of drops contributes to an increase in the severity of adverse reactions. To eliminate them, you must stop using the drug, rinse your eyes with running water and seek medical help.

4. Tevodex is a combined medicinal product, which includes antimicrobial and corticosteroid components. It has pronounced bactericidal and anti-inflammatory properties. Contains tobramycin (broad-spectrum antibiotic) and dexamethasone (corticosteroid with anti-inflammatory effect). It is available in the form of ophthalmic ointment and eye drops.

• Indications: inflammatory eye diseases with or without bacterial infection. Treatment and prevention of infectious and inflammatory eye diseases after surgery. Injuries of the eye, prevention of infectious and inflammatory pathologies.
• Method of application: the drops are intended for instillation into the conjunctival sac 1-2 drops every 4-6 hours. Ointment is also applied to the conjunctival sac of the affected eye 3-4 times a day.
• Side effects: local allergic reactions, burning, dry eyes and eyelids, temporary reduction in visual acuity, keratitis, edema of the conjunctiva. In isolated cases, development of cataract, photophobia, mydriasis, glaucoma was noted.
• Contraindications: hypersensitivity to the components of the drug. It is not prescribed for the treatment of patients with eye infections caused by the herpes virus, fungi, tuberculosis or mycobacteria. With special care is prescribed for glaucoma and thinning of the cornea.

5. Levomekol is a combined agent with chloramphenicol antibiotic and methyluracil immunostimulant. Produced in the form of ointment. It is used to treat purulent-inflammatory skin diseases, with furuncles, trophic ulcers, burns of 2-3 degrees.

The ointment is applied to the affected area and, if necessary, covered with a sterile tissue. The course of treatment is individual for each patient. Levomecol can cause local allergic reactions that go away after the drug is withdrawn. Not used when hypersensitivity to its components.

Vitamins

To accelerate recovery after surgery to eliminate the skin atrophy of the eyelids, patients are prescribed not only medicines, but also microelements necessary for the eyes and organism. Vitamins help to improve eyesight and maintain normal eye function.

As a rule, patients are prescribed such vitamins:

• A - retinol is a component of the ocular pigment of rhodopsin. Deficiency of this substance reduces visual function.
• C - ascorbic acid is necessary for strengthening the walls of the eye vessels and capillaries. It is on their strength that the speed of feeding the tissues of the eye depends. Vitamin C deficiency increases the risk of intraocular hemorrhage.
• Vitamins of group B - have high antioxidant activity. Participate in the process of formation of the visual impulse, interact with retinol. They are responsible for the metabolism of the nervous tissue.
• E - tocopherol stabilizes the state of cell membranes, has antioxidant properties. Protects against negative ultraviolet radiation and bright light.

The above substances can be obtained with food or buy special vitamin complexes for the eyes:

• Riboflavin - appointed with rapid eye fatigue, impaired visual function. Accelerates the healing process of wounds caused by surgical interventions, trauma or eye preparations. Reduces tension and improves visual functions, quickly stops the inflammatory process.
• Viziomax - contains plant extracts. Improves vision, minimizes the risk of developing ophthalmic diseases. Promotes restoration of visual functions, improves overall health.
• Vitafakol - vitamins, which purify the lens and eliminate dryness. Can be used as a remedy at the first stages of cataract.

All vitamins and vitamin complexes should be used after consultation with an ophthalmologist. The doctor will choose the perfect remedy for maintaining eye health and preserving vision.

Physiotherapeutic treatment

To accelerate recovery after blepharochalasis surgery, patients are prescribed physiotherapeutic treatment. Physiotherapy is necessary for:

• Sanitation of foci of chronic infection.
• Toning and stimulating local immunity.
• Mobilization of the body's defenses.
• Restoration of the function of the sebaceous glands of the eyelids (secreteness).

Consider the most effective physiotherapy:

1. Low-frequency magnetotherapy - it stops inflammation and edema of the eyelids, promotes resorption of infiltrates, speeds up metabolic processes, improves trophism of tissues. Increases the activity of blood plasma elements and proteins, improves local blood flow and enhances blood supply to the eyelids.
2. Local darsonvalization of the eyelids - by means of pulsed mid-frequency currents, irritation of the nerve endings of the reflex zones occurs. Thanks to this, the vegetative nervous system is affected, the blood supply improves, and tissue trophism is enhanced.
3. Secrecy stimulation - eyelid massage improves blood flow and lymph flow, strengthens the tone of the neuromuscular system, restores the secret of meibomian glands and eliminates stagnation in the eyelids. Massage can be carried out simultaneously with the installation of medicines.

But physiotherapeutic treatment of blepharohalasis, like any therapeutic method, has certain contraindications to the use. Treatment is not carried out with pronounced suppuration in the eyes and appendages, with fever, malignant neoplasms of the eye.

Alternative treatment

To treat atrophy of the skin, the upper or lower eyelids use not only traditional, but also unconventional methods. Alternative treatment of blepharohalasis:

• Take a pair of onions and boil them until soft. After cooling, strain. Add a mild honey to the broth and rinse with this solution the eyes and skin of the eyelids 4-5 times a day.
• 100 g of peeled fresh cucumbers, pour 250 ml of boiling water and add ½ teaspoon of soda. Use a solution for lotions.
• 25 grams of fennel seeds or chopped dill grass, brew 250 ml of boiling water, and let it brew until it cools. Strain, and used for lotions.
• Mix in equal proportions by weight such ingredients: birch leaves, wild rose leaves, strawberry leaves, St. John's wort, red clover. Grind all ingredients until smooth. A teaspoon of the mixture pour 50 ml of boiling water and insist for 30-40 minutes. Strain. Use the broth for compresses 2-3 times a day.

In addition to the above-described recipes, therapeutic properties are self-massage. It tones the tissues of the eyelids and eyes. With the help of nails can be a reflex massage. To do this, gently prick your eyelids for 2-3 minutes 1-3 times a day.

Herbal Treatment

Another option of alternative therapy for ophthalmic diseases is the treatment with herbs. With blepharohalasis, you can use these recipes:

• 15-25 grams of cornflower flowers without baskets brew 250 ml of boiling water, insist for an hour and strain. Infusion is used as a disinfectant and anti-inflammatory agent. The course of treatment is 4-5 days.
• 15-25 g of crushed oak bark, pour 500 ml of vodka, and boil over medium heat for 15-30 minutes. Strain and cool. The broth is suitable for washing and compresses with pronounced inflammatory processes.
• 30 g of ground psyllium seed is placed in a glass bowl. Add to the vegetable component 2 teaspoons of cold water and shake well. Pour 6 tablespoons of boiling water into the container and continue shaking until the medium has cooled down completely. Strain and use as a lotion.
• Take a tablespoon of chamomile flowers and pour 250 ml of boiling water. Let it brew for 10 minutes, strain and cool. The finished product can be stored in the refrigerator. The broth is used for lotions on the eyes. According to this recipe, you can prepare a decoction of celandine, which is also suitable for lotions.

If you did not find ingredients for the recipes described above, you can use compresses from freshly brewed black or green tea. To eliminate the dryness of the eyelids, milk should be added to the drink.

Surgery

The conservative method of eliminating such pathology as blepharohalasis has not been developed to date. Surgical treatment is the only way to stop the progressive growth of the skin of the eyelids.

Blepharoplasty is an operation to correct or change the shape of the eyelids. Excision of superfluous tissues is directed both on correction of a defect, and on aesthetic rejuvenation of the patient. With the help of the operation it is possible to tighten the upper and lower eyelids, giving the look easy and open. After the procedure, the number of wrinkles on the eyelids decreases.

Indication for surgical intervention:

• Atrophy of the tissues of the upper eyelids and their saccular dangling.
• Presence of bags under the eyes.
• The presence of fatty glands under the eyes.
• A large number of wrinkles in the lower eyelid.
• Pathologies and birth defects.
• Omission of the corners of the eyes.

Contraindications to blepharoplasty:

• Inflammatory process in the body with increased temperature.
• The presence of acute or chronic respiratory disease.
• Hepatitis.
• Diabetes mellitus type 1 or type 2.
• Infectious or oncological diseases.
• Pregnancy and lactation.
• The patient is under 18 years old.
• Violation of blood clotting.
• Acute course of internal diseases.
• Hypertension.
• Increased intracranial pressure.
• Infectious diseases of the nose or eyes.
• Thyroid dysfunction.

Surgical treatment is carried out in ambulatory or hospital settings under local anesthesia. The operation lasts 1-3 hours. With blepharohalasis, such procedures are shown:

• External lifting aponeurosis folds.
• Blepharoplasty.
• Removal of sebum.
• Lateral cantoplasty.

For surgery on the upper eyelids, the doctor makes an incision on the natural fold. The incision slightly touches the area above the outer corner of the wrinkles that appear when smiling. Through the incisions, excess skin and fat tissue are removed. As the restoration is restored, the incision becomes invisible, since it repeats the normal contour of the upper eyelid. In the operation on the lower eyelids, the incision is made below the line of the lower lashes. Through an incision, remove adipose tissue, muscles and excess skin. To eliminate swelling, the doctor can redistribute the tissues.

The excision of tissues can be carried out with the help of a scalpel or laser method. Laser blepharoplasty allows you to remove excess skin around the eyes, change their size or shape, eliminate wrinkles, swelling. The procedure is carried out using an erbium or carbon dioxide CO2 beam.

After surgical treatment the patient is waiting for a recovery period, the duration of which is individual for each patient. In the early days you need to rest. Increased activity can lead to such operational complications as swelling and bruising. Sutures, as a rule, are removed for 4-5 postoperative day. Initially, scars have a pink color, but after 2-3 months they become invisible.

It is worth paying attention to the fact that immediately after the operation, vision can be clouded and remain so for several days. In addition, photosensitivity, increased tear, dry eyes. To eliminate these symptoms use special medicines (drops, ointments). It is also recommended to wear sunglasses for 2-3 weeks after surgery to protect the eyes from sun irritation and wind.

Prevention

Blepharhalasis, like any other disease, is much easier to prevent than treat. Prevention is based on the observance of a healthy lifestyle. It is established that this pathology often occurs in patients with lipid metabolism disorders, that is, obesity.

To prevent skin atrophy of the eyelids, you need to monitor your physical health and body weight. It is recommended to adjust the diet and pay more attention to sports. Also, do not forget about the cosmetic procedures, whose action is aimed at increasing the elasticity of the skin of the eyelids.

If there is a genetic predisposition to the disease, you can consult with an ophthalmologist or a plastic surgeon in advance. The doctor will give recommendations on the proper care of eyelid skin, which will reduce the risk of atrophic changes.

[66], [67], [68]

Forecast

Blepharhalasis, with properly conducted surgical treatment has a favorable prognosis. If you let the disease into its own right, it will lead to several problems at the same time. First of all, it is a cosmetic defect that will lead to mental health problems (self-doubt, depression). Sane skin can close the pupil, hindering eyesight. Trauma to the skin folds can lead to serious ophthalmic diseases. Timely appeal for medical care and treatment, will preserve the beauty of the eyes.