Successful Medical Treatment of Blepharochalasis: A Case Series

ABSTRACT Introduction: Blepharochalasis describes recurrent attacks of idiopathic transient painless oedema in the adnexal tissue of the orbit with the most severe reaction in the skin and orbicularis region. This may produce permanent tissue changes associated with thinning of the eyelid skin. Previous reviews have concentrated on surgical correction of the excess skin and orbicularis created by the condition. There has, as yet, been no report of successful medical management. Patients and Methods: We report here on 4 males and 2 females aged between 37 and 78 years. Systemic acetazolamide (initially 250 mg SR OD), was used in combination with a topical steroid (hydrocortisone cream). Results: All 6 patients achieved relief of their symptoms, with decreased incidence of occurrence and duration of episode if not complete resolution. Conclusion: Oral Acetazolamide in combination with topical hydrocortisone provides effective relief of the periorbital oedema associated with blepharochalasis. In our short series, the cases were improved either with medical therapy alone or in combination with surgery. Relapses following surgery were diminished as a result of prior medical therapy.