Eyelid Research Articles

Malar bags: clinical features and therapeutic options.

Malar bags are a common aesthetic concern characterized by swelling and puffiness in the prezygomatic space and cheek area. Various medical and surgical techniques have been developed to address this condition and restore a more youthful and rejuvenated appearance. In terms of medical therapies, non-invasive options such as topical creams containing retinoids, peptides, and hyaluronic acid have shown promise in reducing mild malar bags. These substances help improve skin texture, promote collagen production, and enhance skin elasticity, thereby reducing the appearance of swelling and puffiness. Additionally, injectable treatments such as dermal fillers have been utilized to camouflage malar bags and create a smoother contour. By strategically placing fillers in the surrounding areas, a skilled practitioner can achieve a more harmonious facial appearance. In recent years, advancements in radiofrequency have also shown promise for treating malar bags. Laser skin resurfacing procedures can help tighten the skin, stimulate collagen production, and reduce the appearance of swelling and wrinkles in the malar area. For patients seeking more lasting results, surgical techniques provide viable options. Blepharoplasty, a surgical procedure aimed at correcting eyelid issues, can be performed to remove excess skin and fat deposits in the lower eyelid, effectively addressing malar bags. Additionally, newer techniques like endoscopic surgery allow for minimal incisions and reduced scarring, making them appealing to patients concerned about visible postoperative marks. Although numerous medical and surgical techniques are available, the choice of treatment depends on factors such as the severity of the condition, patient preferences, and the expertise of the medical practitioner. In this manuscript we have made a retrospective evaluation of the medical and surgical therapies of malar bags and we report our considerations after 20 years of experience.

The correlation of clinical and histopathological features of eyelid malignancies: a 5-year retrospective study in Vietnam.

To analyze the correlation between the clinical and histopathological features of eyelid malignancies in Vietnam. An observational retrospective study was conducted on 190 patients who were diagnosed histopathologically after surgery with eyelid malignancies between 2017 and 2021 at Vietnam National Eye Hospital. Demographic, clinical manifestations, pathological features and outcomes were analyzed. Basal cell carcinoma was the most common histopathologic type, accounting for 57.9% of cases, followed by sebaceous gland carcinoma at 27.4%. The match between clinical diagnosis and pathological diagnosis was 57.4% across all cases. The majority of basal cell carcinoma cases presented on the lower eyelid, while the majority of sebaceous gland carcinoma cases presented on the upper eyelid. Clinical features with the highest clinical correlation were ulceration (76.4%) for basal cell carcinoma and ill-defined edges (84.6%) among malignant cutaneous melanoma. Eyelid malignancies present significant challenges in clinical diagnosis, with only moderate concordance between clinical and histopathological findings. Basal cell carcinoma is the most common eyelid malignancy in Vietnam, though its incidence is significantly lower than in Western countries. Clinical findings with the most consistent clinical correlation were high rates of ulceration in basal cell carcinoma and ill-defined edges in malignant melanoma.

Case Report: Solitary fibrous tumor of the eyelid in a child: a case report and review of the literature

Introduction Solitary fibrous tumors (SFT) are typically characterized by the proliferation of CD34-positive specialized fibroblasts. While these tumors are most found in the pleura, they can also present in extra-pleural sites, including the orbit, particularly in adults. Herein, we report a rare case of SFT of the eyelid in a pediatric patient and review the existing literature on similar cases. Methods A case of a 5-year-old male with a nodule on the eyelid margin is presented. The nodule was completely resected and histopathologically confirmed as SFT. A comprehensive review of the published cases of eyelid SFT was conducted. Results The case represents the second reported instance of eyelid SFT in a pediatric patient and is the youngest case documented to date. The tumor’s histopathological examination revealed characteristics consistent with SFT. The review of the literature identified only 10 cases of eyelid SFT in English literature, with just one previously reported in the pediatric population. Conclusion SFT of the eyelid is extremely rare, especially in pediatric patients. Despite its rarity, SFT should be considered in the differential diagnosis of vascular spindle-cell tumors of the eyelid in this age group. Early recognition and complete resection are crucial for effective management.

The Eye of the Largest Forest Raptor, the Harpy Eagle (Harpia harpyja): Morphologic Observations and Reference Values for Selected Ophthalmic Tests.

To carry out a descriptive investigation of the most relevant morphological features of the harpy eagle eye and to provide normative data for selected ophthalmic diagnostic tests. Twenty-nine clinically normal harpy eagles (Harpia harpyja). Selected morphological ocular observations were made in live animals under physical restraint: Schirmer tear test (STT), culture of normal conjunctival flora, slit lamp biomicroscopic examination of adnexa and anterior segment, rebound tonometry, applanation tonometry, central corneal thickness (CCT), palpebral fissure length (PFL), B-mode ultrasound, and ocular biometry. Eyelid histology was evaluated from previously deceased individuals. STT type I 17.48 ± 5.476 mm/min; Rebound tonometry 14.00 IQR 4.00 mmHg; Applanation tonometry 15.00 IQR 6.00 mmHg; CCT 0.563 ± 0.041 mm; PFL 26.42 ± 2.13 mm; Axial globe length 29.43 IQR 0.42 mm; Anterior chamber depth 5.00 IQR 0.22 mm; Axial length of the lens 6.60 IQR 0.97 mm; Vitreous chamber depth 16.50 IQR 0.80 mm, and pecten length 8.80 IQR 1.47 mm. The conjunctiva of the lower eyelid has a distinct cartilaginous plate adjacent to the conjunctival epithelium. The most frequent conjunctival bacterial isolates were E. coli (32.76%) followed by Enterobacter spp. (15.52%) and Streptococcus spp. (10.34%). Reference data and morphologic observations obtained in this investigation might aid in the understanding and diagnosis of eye diseases in harpy eagles and improve the clinical management of ocular disease.

Efficacy and utility of clinical examination in predicting meibomian gland atrophy.

Efficacy and utility of clinical examination in predicting meibomian gland atrophy.

The Role of Perforator Island Flaps for the Reconstruction of Mid-Facial and Periorbital Large and Deep Defects.

To describe a single-hospital experience with the reconstruction of broad and deep periorbital defects with perforator island flaps (PIFs). Twenty cases of reconstruction of complex defects in the periocular region using PIF were selected and revised. All cases were performed in the university hospital of the University of São Paulo, Ribeirão Preto, Brazil, from September 2018 to July 2024. Data collected included intraoperative and postoperative photographic documentation, lesions diagnoses, defect sizes and locations, PIF sizes and axes of mobilization, postoperative follow-up duration, and complications. All patients underwent periorbital reconstruction with PIF after tumor resection. In 7 cases, the defects involved the lower lid cheek junction, and in 10 cases, they extended into the medial canthus, including 3 cases of orbital exenteration. The lateral periorbital region was affected in 2 patients. The mobilization of the flaps was from the lower cheek toward the lower eyelid in 7 patients, toward the medial canthal area in 10 patients, and horizontally to cover defects in the medial and temporal regions in 2 cases. The size of the resultant defect averaged 7.9 cm2. The mean follow-up time was 40 months. The flap remained viable in 100% of cases. PIFs are a versatile option for reconstructing large periorbital defects and extended exenterations, and this technique should be included in the repertoire of procedures for managing mid-facial tumors.

Management of Oxidative Stress and Inflammation in Patients with Symptomatic Dry Eye Disease Treated with a Preservative-Free Ophthalmic Emulsion Combining Alpha-Lipoic Acid and High Molecular Weight Sodium Hyaluronate.

This study aimed to explore the beneficial effect of a preservative-free (PF) emulsion eyedrop combining high molecular weight sodium hyaluronate (HMW-HA) and alpha-lipoic acid on oxidative stress and ocular surface inflammation in patients with dry eye disease (DED). In this prospective exploratory study, patients with moderate to severe DED symptoms were treated with the study eyedrop, 4-6 times/day for 1month. Two visits were scheduled: baseline (D0) and after 35days (D35). The following parameters were assessed: quality of life (OSDI score); superoxide dismutase (SODase) concentration in tears; goblet cell (GC) density (impression cytology); conjunctival hyperemia (Efron scale); corneal, conjunctival, and eyelid staining (Oxford scale); and meibomian gland (MG) blockage. Data were compared between D0 and D35 in subgroups of patients with a significant abnormality of the study outcome at baseline. Forty patients were involved, with a highly significant improvement of OSDI score at D35. The mean concentration of SODase significantly increased by 3.2 and 2.4 times for SODase1 and SODase2 respectively, in patients with deficient SODase at baseline. In patients with abnormal GC density at baseline, GC count increased by five times at D35. Conjunctival hyperemia and corneal staining scores significantly improved in the subpopulation of patients with a baseline grade ≥ 2. Eyelid margin staining was significantly reduced at D35 in patients with significant abnormalities at baseline. A significant reduction of MG obstruction was shown in the lower eyelid in patients with significant blockage at baseline. The use of a PF ophthalmic emulsion combining alpha-lipoic acid and HMW-HA shows a beneficial effect on the ocular surface through the improved quality of life score. Noteworthy, patients presenting high oxidative and inflammatory conditions experienced significant improvement in oxidative stress and inflammation markers; this synergic effect is likely due to the well-known properties of alpha-lipoic acid and HMW-HA, enhancing DED management. ISRCTN.com identifier, 17861788.

A Novel Dual-Catheter Drainage Technique for Prevention of Orbital Hematoma in Blowout Fracture Surgery.

Retrobulbar hematoma after blowout fracture surgery is a devastating complication that can lead to permanent vision loss. When such complications occur, emergency interventions like lateral canthotomy are often required, resulting in additional tissue trauma. This study presents a novel dual-catheter drainage technique designed to prevent postoperative orbital hematoma formation. Eight consecutive patients who underwent orbital wall reconstruction between October 2024 and December 2024 were included in this study. The technique involves placing 2 modified 18-gauge angiocatheters: one positioned above the orbital plate toward the inferior orbital fissure, and another placed horizontally between the lower eyelid musculature and orbital bone. Four to 5 small holes were created around each catheter to enhance drainage efficiency. Initial experience with a single catheter in 1 patient resulted in postoperative lower eyelid hematoma. After modification to a dual-catheter system, 7 subsequent cases demonstrated successful prevention of orbital hematoma formation. Significant drainage was observed during the first 48 hours postoperatively in all cases. No complications, such as infection, ectropion, or permanent diplopia, were observed. The catheter system was maintained for 2 to 3 days postoperatively, with consistent catheter occlusion noted by day 3 due to blood clot formation. This novel dual-catheter drainage technique demonstrates effectiveness in preventing postoperative orbital hematoma after blowout fracture surgery. The method's simplicity, minimal invasiveness, and strategic anatomic coverage make it a valuable approach for reducing postoperative complications and improving surgical outcomes. Further studies with larger patient cohorts are warranted to establish the technique's broader applicability.

The von Gräfe sign measurement

ABSTRACT Purpose To measure the amplitude of upper eyelid saccadic movements in patients with Graves’ retraction. Methods The amplitude and velocity of lid saccades were quantified using customized software in 36 patients with Graves’ upper eyelid retraction (GO) and in 32 subjects of a control group (CG). All patients were in the chronic phase of the disease and had a controlled thyroid status. Eyelid retraction was measured using the software ImageJ. Levator palpebrae superioris muscle (LPSM) dimensions were measured through orbital computed tomography (CT). Results The mean MRD1 was 6.5 mm and 3.9 mm in the GO and CG groups, respectively. The LPSM was radiologically enlarged in patients. The absolute values of both amplitude and velocity of lid movement did not differ between the two groups. However, considering the final position of the lid margin in relation to the pupil in downgaze, the margin-reflex distance of the patients was significantly higher than that of the controls. Conclusion In patients with upper eyelid retraction in inactive GO the relaxation of the LPSM are not affected, despite the muscle enlargement. However, the amplitude of the downward lid movement of the patients does not compensate for the lid retraction. The final position of the lid margin of the patients in downgaze is significantly higher than in controls, indicating the inability of the LPMS relaxation to overcome lid retraction. The von Gräfe sign is thus a relative phenomenon and not an absolute indication of loss of the lid elastic properties.

Lower Eyelid Blepharoplasty for Cosmetic Correction of Eyeliner Tattoo Pigment Migration.

Lower Eyelid Blepharoplasty for Cosmetic Correction of Eyeliner Tattoo Pigment Migration.

Eyelid and Canalicular Reconstruction in Peripunctal Tumors: Single-Center Experience Over Seven Years.

Retrospective, noncomparative, and interventional case series. Peripunctal tumors are uncommonly encountered. The management at the aesthetically and functionally sensitive area is demanding. This study aims to evaluate the effectiveness of sliding flaps in combination with stenting to reconstruct eyelid margin and proximal canaliculus. The study was conducted between January 2017 and December 2023 at Beijing Tongren Eye Center. Demographic data, clinicopathological spectrum postoperative outcomes of patients with peripuntal lesions receiving primary surgical treatment, and histopathological analysis were collected and assessed. The single-stage procedure combined sliding tarsoconjunctival flap and myocutaneous flap with bicanalicular stent placement to repair the defect after full-thickness block resection of the lesion. A total of 66 Han Chinese patients (68 eyelids) were included. The mean age at surgery was 43.6 years (range, 5-75y). All cases were unilateral, and 2 cases were diagnosed as divided nevus-affected opposing eyelids. The lower eyelid was most frequently involved (49/68, 72%). Two patients had epiphora on presentation, whereas the lacrimal drainage system was patent in all patients. The most common lesion was melanocytic nevus (57/68, 84%). There were 2 malignant cases confirmed to be basal cell carcinoma. During the follow-up period (3-70mo), all the patients were satisfied with the surgical outcomes. Only 1 patient with a well-positioned and patent punctum reported epiphora. Although rare, a high index of suspicion for malignancy should be maintained when treating peripunctal lesions. The procedure of sliding flaps combined with bicanalicular intubation provides an effective and less invasive strategy for medial eyelid margin reconstruction.

JALOUKAVACHARANA IN THE MANAGEMENT OF CONJUNCTIVAL PYOGENIC GRANULOMA (VARTHMARBUDHA) : A SINGLE CASE STUDY

Introduction: Conjunctival Pyogenic Granuloma is the most prevalent benign vascular growth appearing as a smooth, red, sessile/pedunculated lesion on the palpebral conjunctiva. The patient's eye is irritated by the growth in the palpebral region, which interferes with daily activities. On a very slight trauma, these lesions frequently bleed. Based on the symptoms, pyogenic granuloma can be correlated with Vartma Arbudha. Case: A 29-year-old male patient presented to our OPD with a complaint of mild irritation in the left eye with a painless lesion grown in size over 5-6 days. On examination, a non-tender, mobile, thick red polypoidal papule with irregular margins measuring about 5-6 mm in length over the palpebral conjunctiva of the lower eyelid was examined. Based on complaints and examination findings, the patient was diagnosed with Pyogenic Granuloma of the low-er palpebral conjunctiva (Vartma Arbudha). Treatment: Vartma Arbudha is caused by the vitiation of Rakta and Tridosha. Hence, Raktamokshana by Jalouka was adopted,orally with Kanchanara Guggulu, and Opthocare Eye drops for instillation in the affected eye. Result: After the therapy, a noticeable reduction in the lesion size was seen, and symptomatic relief from irritation and discomfort was observed within one week. Discussion: Vartma Arbudha is a Rakta Pitta Pradhana Sannipataja Vyadhi. Raktamokshana is considered the best among the vitiat-ed Rakta and Pitta treatment modalities. Jaloukavacharana, one among Raktamokshana mainly indicated in Pit-taja Vyadhi, eliminates vitiated blood from the application region. Kanchnara Guggulu has the Shothahara property, which reduces swelling. Opthacare eye drops have a smoothening effect on the eye, reducing asthe-nopic symptoms. Conclusion: The adoption of Jaloukavacharana along with oral shothahara dravyas helps in better management of Pyogenic granuloma.

Innovative Syringe-Guided Barbed Sutures for Orbital Fat Repositioning: A Retrospective Study.

To investigate the clinical efficacy of a method that corrects tear trough deformity by subcutaneous fixation of orbital septal fat flaps using syringe-guided absorbable barbed sutures. A retrospective analysis was conducted on the clinical data of 125 cases with lower eyelid bags accompanied by tear trough deformity who were treated in the Department of Plastic Surgery at Zhengzhou People's Hospital from 2020 to 2024. Among them, there were 13 males and 112 females, with an average age of 34.2 ± 6.8 years. A 1 to 1.5cm horizontal transconjunctival incision was made to release the orbital septal fat, forming a pedicled fat flap. The premaxillary space and part of the prezygomatic space were dissected. A syringe needle was bent and vertically inserted through the deepest point of the tear trough depression into the dissected space. One to 2 absorbable barbed sutures were passed through the central part of the fat flap. The tail end of the suture was inserted into the bent needle. The needle was retracted subcutaneously (the needle remained subcutaneous throughout), exited through another tunnel, and then a knot was tied to fix the fat flap at a position satisfactory to both the surgeon and the patient. The Tear Trough Rating Scale scores were assessed preoperatively and at 6 months postoperatively. The Tear Trough Rating Scale scores at 6 months postoperatively were significantly lower than those preoperatively (P < 0.05), indicating a marked improvement in tear trough deformity. No complications, such as lower eyelid retraction, ectropion, or hematoma, occurred in any patient. The method of subcutaneous fixation of orbital septal fat flaps using syringe-guided barbed sutures effectively improves tear trough deformity and midfacial depression.

A Case of Juvenile Dermatomyositis Presenting with Inverse Gottron’s Papules: A Case Report

Introduction: Inverse Gottron’s papules is an uncommon presentation of dermatomyositis, with a paucity of studies published in children with juvenile dermatomyositis (JDM). Case presentation(s): A five-year-old girl presented with progressive bilateral eyelid erythema and edema, mild erythematous rash over the face, painful palmar papules (inverse Gottron’s papules), and proximal muscle weakness for three months. Additional symptoms included intermittent fever, decreased appetite, joint pain, and mild abdominal pain. Physical examination revealed upper and lower eyelid erythema with mild edema (heliotrope sign), Gottron’s papules over the dorsal distal Interphalangeal joint (DIP), Gottron’s sign over the dorsal metacarpophalangeal (MCP) joints, proximal interphalangeal (PIP) joints, and elbows, Inverse Gottron's sign over the palmar surface of the hands (PIP and DIP), and ragged nailfold cuticles with no dilated capillaries. Laboratory investigations showed elevated muscle enzymes, positive myositis-specific antibodies, and elevated liver function tests. High-resolution computed tomography (HRCT) chest revealed no signs of interstitial lung disease (ILD). Whole-body magnetic resonance imaging (MRI) revealed bilateral upper limb subcutaneous edema and generalized myositis, particularly in the pelvis and thigh muscles, confirming the diagnosis of JDM. Treatment involved intravenous methylprednisolone 30 mg/kg/day for three days followed by tapering, and topical corticosteroids over dermatomyositis-affected areas. Conclusion: Inverse Gottron’s papules is an uncommon cutaneous manifestation of dermatomyositis (DM) that has an association with ILD in both adults and children. Thus, patients with dermatomyositis and inverse Gottron’s papules should be investigated for ILD. Our patient represents the first reported case of JDM with inverse Gottron’s papules in Saudi Arabia.

Evaluation of vitamin D and serum lipid profile levels in obstructive meibomian gland dysfunction.

Evaluation of vitamin D and serum lipid profile levels in obstructive meibomian gland dysfunction.

Bilateral carotid-cavernous fistulas following trauma: A rare case of diagnostic and management challenges.

A 23-year-old male presented with a 6-month history of left eyelid swelling and a 2-week history of headaches following a road traffic accident. Examination revealed left eye proptosis (23mm vs. 19mm on the right, normal 16mm), limited abduction of the right eye, incomplete closure of the right upper eyelid, and right facial nerve weakness. No relative afferent pupillary defect (RAPD) was noted. Musculoskeletal ultrasound of the left eyelid identified an elongated subcutaneous cystic lesion with intense vascularity, indicative of a vascular lesion. CT of the facial bones with 3D reconstruction revealed bilateral proptosis, dilated superior ophthalmic veins, and enlarged cavernous sinuses, consistent with bilateral carotid-cavernous fistulas (CCFs). Otomastoiditis with facial nerve canal dehiscence was also noted, suggesting facial nerve involvement. MRI brain and orbit with gadolinium contrast demonstrated multiple dilated tortuous vascular structures communicating with the cavernous sinuses, dilated bilateral superior ophthalmic veins (left > right), and left eye proptosis, consistent with high-flow fistulas. High-flow characteristics were supported by early arterial filling of the cavernous sinuses, retrograde venous drainage, and superior ophthalmic vein dilation on MR angiogram. Bilateral CCFs are rare, typically resulting from trauma, and often present with proptosis, cranial nerve deficits, and orbital symptoms. Fundus examination revealed engorged retinal veins and mild optic disc swelling in the left eye, consistent with venous stasis. Endovascular surgery is the gold standard for treatment; however, this patient was managed symptomatically with analgesics due to financial constraints. This case demonstrates the importance of imaging in diagnosis and highlights the challenges of managing CCFs in resource-limited settings.

Current surgical techniques for correction of age-related upper eyelid changes in Asian patient race

Objective. To identify current surgical techniques for correction of age-related upper eyelid changes in Asian patients through analysis of available information in scientific databases. Material and methods. Available literature data were reviewed in the PubMed, Google Scholar and the Russian State Library databases. The inclusion criteria were clinical studies describing surgical correction of age-related upper eyelid changes in Asian patients and possible intraoperative and postoperative complications. There were 64 (100%) manuscripts including 30 (46.8%) ones devoted to age-related Asian blepharoplasty, 21 (32.8%) — blepharoplasty through subbrow approach, 4 (6.2%) — combination of techniques, 4 (6.2%) — blepharoplasty through supraciliary approach, 5 (8%) — upper eyelid lipofilling. Results. The most common methods of surgical correction of age-related upper eyelid changes in Asian patients are upper blepharoplasty (several variations of techniques), blepharoplasty through subbrow approach, blepharoplasty through supra-ciliary approach, combination of techniques with lipofilling and/or excision of fatty hernias. The most common techniques are upper blepharoplasty with creation of palpebral fold and blepharoplasty through subbrow approach for excision of lateral hood-shaped overhang without palpebral fold correction. Blepharoplasty through supra-ciliary approach is less common since it does not allow excision of large volume of dermatochalasis. Conclusion. Available literature does not describe the algorithm of preoperative management using non-invasive diagnostic methods and postoperative management of Asian patients. There are no indications and contraindications for various surgical options taking into account the characteristics of age-related changes in these patients. There is no algorithm for choosing surgical technique depending on eyelid shape and personal wishes of patients with age-related changes. Blepharoplasty through subbrow approach is effective for lateral upper eyelid ptosis and preferable for lateral dermatochalasis in Southeast Asians. However, myoperiosteal sutures or fixation to frontal muscle creates a high risk of damage to vascular-nerve bundles. It is necessary to refine modern techniques to reduce the incidence of possible complications.

Upper Eyelid Blepharoptosis Correction Performed Under the Operating Microscope.

Eyelid blepharoptosis correction is commonly performed with loupe magnification. The posture in which this operation is performed, with cervical spine flexion and forward lean, places significant stress on the cervical spine. Performing upper eyelid surgery under the operating microscope is not commonly practiced. The benefits are significantly better surgeon's posture while operating and potential improved surgical outcomes. These ergonomic and outcome measures were examined in this prospective study. From the June 2023 to June 2024, 86 cases of bilateral ptosis correction were performed (172 eyelids) with the microscope. The mean duration of surgery was 115 minutes for bilateral ptosis correction. Our revision rate was 3%. We found the following surgical advantages with this approach: (1) Superior visual clarity with a higher and adjustable magnification and (2) consistent confocal illumination of the operative field, (3) improved precision of dissection, (4) hemostasis and (5) clear distinction of fine anatomical structures crucial to reconstructive success. The postoperative recovery was faster with better functional and cosmetic outcomes as bruising and edema was minimized from less induction of surgical trauma. Importantly as well, for the surgeon, the operating microscope may extend the longevity of one's surgical career. The postural ergonomics and cervical unloading afforded by the operating microscope can mitigate cervical spine stress and injury CONCLUSIONS: We found 2 compelling benefits with this approach. Firstly, the surgical outcomes were superior. Secondly, the surgeon's posture is upright while operating. This long-term benefits of this could not be overstated in preventing cervical spineinjuries. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

How We Do It: Reconstruction of Combined Lateral Upper and Lower Eyelid Defects.

How We Do It: Reconstruction of Combined Lateral Upper and Lower Eyelid Defects.

The effect of blepharoplasty or blepharoplasty combined with ptosis or eyebrow surgery to quality of life and use of medication related to headache or eyelid skin disease

ABSTRACT Purpose The aim of this study is to evaluate the effect of blepharoplasty, ptosis or eyebrow surgery to quality of life and use of medication related to headache or eyelid skin disease. Methods A longitudinal, prospective study including 90 consecutive patients who underwent blepharoplasty, ptosis, eyebrow or combined surgery. The quality of life related to headache was evaluated by HIT6™ and to eyelid skin disease by Skindex-Mini SDM. Use of medication was measured by number of days per week medication was used for headache or eyelid skin disease. Results Preoperatively 46 (51%) had headache, 4 (4%) eyelid skin and 2 (2%) headache and eyelid skin symptoms. The median HIT-6 difference was −21 (range –36–0; p < .0001) and the median SDM difference was −13 (range = –15 to –1; p = .036). The median difference in medication days/week related to headache was −1 (range −4–0; p < .0001) and to eyelid skin disease −1.5 (range –3 to –1; p = .034). Conclusions This study shows that after upper eyelid blepharoplasty, ptosis or brow ptosis surgery, headache or eyelid skin disease-related quality of life measures are significantly improved, and the use of headache or eyelid skin-related medication is significantly less.