Distinguishing cause of droopy eyelids determines management approach

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When a patient presents with a dermatochalasis-type picture, it is important to determine the cause, Wendy W. Lee, MD, said at Hawaiian Eye 2013. 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href="/web/20131223080940/http://www.healio.com/optometry"> Optometry</a></li> <li><a class="" href="/web/20131223080940/http://www.healio.com/orthopedics"> Orthopedics</a></li> <li><a class="" href="/web/20131223080940/http://www.healio.com/orthotics-prosthetics"> Orthotics/Prosthetics</a></li> <li><a class="" href="/web/20131223080940/http://www.healio.com/pediatrics"> Pediatrics</a></li> <li><a class="" href="/web/20131223080940/http://www.healio.com/psychiatry"> Psychiatry</a></li> <li><a class="" href="/web/20131223080940/http://www.healio.com/rheumatology"> Rheumatology</a></li> <li><a class="" href="/web/20131223080940/http://www.healio.com/sports-medicine"> Sports Medicine</a></li> </ul> <div id="awardgroup"> <ul class="award-wrap"> <li class="col1"><a href="/web/20131223080940/http://www.healio.com/hematology-oncology/practice-management/news/online/%7Bbaa1a66a-8c99-4530-b5b2-4bd5946fd8c9%7D/healiocom-wins-2012-best-publishing-site-award" rel="nofollow">Sitecore Site of the 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type="text/javascript"> jQuery(".nav>li:last>a").addClass("last"); //fix for IE last-child style </script>   <div id="main-content">  <p id="breadcrumbs"> <a href="/web/20131223080940/http://www.healio.com/"> Healio</a> <span>›</span> <a href="/web/20131223080940/http://www.healio.com/ophthalmology"> Ophthalmology</a> <span>›</span> <a href="/web/20131223080940/http://www.healio.com/ophthalmology/oculoplastics"> Oculoplastics</a> <span>›</span> <a href="/web/20131223080940/http://www.healio.com/ophthalmology/oculoplastics/news"> News</a> </p>    <div id="SeeAlso" class="related-links"> <h3>See Also</h3> <ul><li><a href="https://web.archive.org/web/20131223080940/http://www.healio.com/ophthalmology/oculoplastics/news/print/ocular-surgery-news/%7B6c346288-7a83-47c6-9f83-63d28f98b17f%7D/multiple-surgical-techniques-allow-for-management-of-brow-ptosis">Multiple surgical techniques allow for management of brow ...</a></li><li><a href="https://web.archive.org/web/20131223080940/http://www.healio.com/ophthalmology/oculoplastics/news/print/ocular-surgery-news/%7B2aacd6e6-840d-4087-8bd1-71693badc082%7D/combined-approach-to-lower-lid-blepharoplasty-leaves-orbital-septum-intact">Combined approach to lower lid blepharoplasty leaves orbital ...</a></li><li><a href="https://web.archive.org/web/20131223080940/http://www.healio.com/ophthalmology/oculoplastics/news/print/ocular-surgery-news/%7B655e0036-5076-4413-b39a-d2c9a7d76351%7D/evaluation-and-management-of-congenital-ptosis">Evaluation and management of congenital ptosis</a></li></ul> </div>    <input name="layout_0$maincontent_0$seeAlsoInsertUnderParagraph" type="hidden" id="layout_0_maincontent_0_seeAlsoInsertUnderParagraph" value="1"/>  <div class="content"> <h2> Distinguishing cause of droopy eyelids determines management approach</h2> <h3 class="deck"> </h3> <p class="main-subtitle"> </p> <div class="social-links-top"> <ul class="share"> <li class="l1"><a href="javascript:void(0)" class="facebook-link" target="_new">Facebook</a></li> <li class="l2"><a href="javascript:void(0)" class="twitter-link" target="_new">Tweet</a></li> <li class="l3"><a href="javascript:void(0)" class="linkedin-link">Share</a></li> </ul> </div> <ul class="meta-info"> <li> January 21, 2013</li> </ul> <div class="wyContent"> <p style="margin: 0in 0in 10pt;">WAIKOLOA, Hawaii — There are a number of different causes of droopy or heavy eyelids, and management for each may be different, a speaker said here. </p> <p style="margin: 0in 0in 10pt;">When a patient presents with a <a href="https://web.archive.org/web/20131223080940/http://www.healio.com/ophthalmology/search.aspx?q=dermatochalasis&requiredfields=specialty:Ophthalmology&client=healio_frontend&output=xml_no_dtd&proxystylesheet=healio_frontendCME&site=healio-production&lr=lang_en&filter=p&getfields=*&ie=UTF-8&ip=192.168.100.144&access=p&entqr=3&oe=UTF-8&ud=1&sort=date%3AD%3AS%3Ad1" target="_blank">dermatochalasis</a>-type picture, it is important to determine the cause, <b>Wendy W. Lee, MD,</b> said at Hawaiian Eye 2013. </p> <div class="mug right"><img alt="Wendy W. Lee, MD" src="/web/20131223080940im_/http://www.healio.com/~/media/Images/News Wire Images/Ophthalmology/2013/01_January/Wendy W Lee MD.jpg"/> <p class="name"><strong>Wendy W. Lee</strong></p> </div> <p style="margin: 0in 0in 10pt;">“One of the most important steps in evaluating a patient for a [<a href="https://web.archive.org/web/20131223080940/http://www.healio.com/ophthalmology/search.aspx?q=blepharoplasty&requiredfields=specialty:Ophthalmology&client=healio_frontend&output=xml_no_dtd&proxystylesheet=healio_frontendCME&site=healio-production&lr=lang_en&filter=p&getfields=*&ie=UTF-8&ip=192.168.100.144&access=p&entqr=3&oe=UTF-8&ud=1&sort=date%3AD%3AS%3Ad1" target="_blank">blepharoplasty</a>] is to differentiate,” she said. </p> <p style="margin: 0in 0in 10pt;">Potential causes of eyelid “fullness” include true dermatochalasis, herniation of orbital fat, blepharoptosis, pseudoptosis, <a href="https://web.archive.org/web/20131223080940/http://www.healio.com/ophthalmology/search.aspx?q=%22brow+ptosis%22&requiredfields=specialty:Ophthalmology&client=healio_frontend&output=xml_no_dtd&proxystylesheet=healio_frontendCME&site=healio-production&lr=lang_en&filter=p&getfields=*&ie=UTF-8&ip=192.168.100.144&access=p&entqr=3&oe=UTF-8&ud=1&sort=date%3AD%3AS%3Ad1" target="_blank">brow ptosis</a> or system conditions. For a brow ptosis in particular, blepharoplasty would not be the procedure to use, she said.</p> <p style="margin: 0in 0in 10pt;">“Take a thorough history,” Lee said. Systemic conditions that might cause fullness of upper lids include thyroid eye disease, metabolic disorders, cardiac or hematologic abnormalities, allergy or lacrimal gland disease.</p> <p style="margin: 0in 0in 10pt;">“I’ve seen some patients come in with droopy eyelids or fullness of the lid, and they actually have lymphoma of the lacrimal gland,” she said.</p> <p style="margin: 0in 0in 10pt;">Lee said that often her patients have a combination of causes of heavy lids — for example, brow ptosis and dermatochalasis.</p> <p style="margin: 0in 0in 10pt;">“In those situations, it’s important to see which component is most significant and tackle that first,” she said.</p> <p style="margin: 0in 0in 10pt;">When evaluating such a case in the clinic, Lee said she uses tape to show the patient how each component would be managed to set expectations for the patient.</p> <p style="margin: 0in 0in 10pt;"><strong>Disclosure</strong>: Lee has no relevant financial disclosures.</p> </div>  <div class="fig left"> <p class="figcaption"> </p> </div> <div class="wyPagination">   </div>  <div class="follow"> <img src="/web/20131223080940im_/http://www.healio.com/~/media/Images/News/FollowUs.jpg" id="layout_0_maincontent_1_SocialFollow_socialfollow" name="socialfollow" alt="Follow us" usemap="#followus" border="0"/> <map id="followus" name="followus"> <area id="layout_0_maincontent_1_SocialFollow_followfb" shape="rect" coords="51,5,5,51" target="_blank" href="https://web.archive.org/web/20131223080940/http://www.facebook.com/ocularsurgerynews" alt="Follow us on Facebook"></area> <area id="layout_0_maincontent_1_SocialFollow_followtw" shape="rect" coords="270,3,320,50" target="_blank" href="https://web.archive.org/web/20131223080940/https://twitter.com/OSNSuperSite" alt="Follow us on Twitter"></area> </map> </div> </div>  <div class="social-links"> <div class="fb-like" data-send="false" data-width="300" data-show-faces="true" data-action="recommend"></div> <ul class="share"> <li><a href="javascript:void(0)" id="twitter" class="twitter-link" target="_new">Tweet</a></li> <li><a href="javascript:void(0)" id="facebook" class="facebook-link" target="_new">Share</a></li> <li class="linkedin"><a href="javascript:void(0)" id="linkedin" class="linkedin-link">Link</a></li> <li><span class="db-wrapper"><span class="g-plusone" data-size="tall" data-annotation="none"></span></span></li> <li><a href="javascript:void(0)" id="email">Email</a></li> <li class="last"><a href="javascript:void(0)" id="print">Print</a></li> </ul> <input name="layout_0$maincontent_1$SocialMedia$articleItemForTweet" type="hidden" id="layout_0_maincontent_1_SocialMedia_articleItemForTweet" value="{0D2BE519-F60E-4082-8756-21EC0513724D}"/> <input name="layout_0$maincontent_1$SocialMedia$tweettext" type="hidden" id="layout_0_maincontent_1_SocialMedia_tweettext" class="tweettext" value="Distinguishing cause of droopy eyelids determines management approach "/> <input name="layout_0$maincontent_1$SocialMedia$tweeturl" type="hidden" id="layout_0_maincontent_1_SocialMedia_tweeturl" class="tweeturl" value="http://goo.gl/Iw4ad0"/> </div>  <div id="respond"> <h4> Comments</h4> <script language="javascript" type="text/javascript"> var idcomments_acct = 'aa6ff53f9870e40f92f83e1b5df3cddf'; var idcomments_post_id = '{0D2BE519-F60E-4082-8756-21EC0513724D}'; var idcomments_post_url; </script> <span id="IDCommentsPostTitle" style="display: none"></span> <script type="text/javascript" src="https://web.archive.org/web/20131223080940js_/http://www.intensedebate.com/js/genericCommentWrapperV2.js"></script> <p class="comment-notes"> Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. 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