As people age, the skin around the eyes loses elasticity, causing loose, excess eyelid skin to droop. Health experts refer to this condition as dermatochalasis, which others also call “baggy eyes.”
Dermatochalasis is primarily a cosmetic issue. However, in some cases, it may cause functional problems, such as vision interference, eye irritation, and dermatitis.
In this article, we examine the connection between dermatochalasis and dry eye. We also discuss options for dry eye treatment and prevention.
Dermatochalasis is a term medical professionals use to describe excess eyelid skin, muscle, or fat. It often affects the upper eyelid but can also affect the lower eyelid.
Usually, experts associate dermatochalasis with aging, as it is more common in middle-aged and older adults. Certain conditions and surgery can also cause dermatochalasis.
Tears are essential in keeping the eye surface clear and smooth, washing away foreign particles, and preventing eye infections.
Dry eye is a condition where the eyes do not produce enough tears to lubricate the eyes or where tears evaporate too quickly. A person with dry eyes does not have enough moisture coating their eyes, which can affect vision and damage the surface of the eyes.
In people with dermatochalasis, the eyelids do not work as efficiently to keep the eye surface moist, leading to dry eyes.
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Many people with dermatochalasis undergo eyelid surgery, or blepharoplasty. This surgical procedure involves removing the excess eyelid fat and skin to improve appearance and vision.
According to a 2020 review, blepharoplasty causes dry eye syndrome in around
Experts associate blepharoplasty with dry eye syndrome, because it reduces a person’s blink rate and causes incomplete eye closure, or lagophthalmos. This diminishes tear film distribution, increases tear evaporation, and impairs the removal of foreign particles from the eye surface.
A 2021 review also notes that the risk of having dry eye syndrome could increase after eyelid surgeries, such as blepharoplasty and ptosis surgery.
It is common for dry eyes to occur after blepharoplasty. However, doctors may use measures before, during, and after the surgery to prevent the development of the condition due to the procedure.
Individuals are at higher risk of dry eyes if they have:
- had an eye surgery before
- a history of dry eye syndrome
- dry eye symptoms
- certain lifestyle and routines
Habitual eye rubbing can be a sign of dry eyes, and smoking
Moreover, prolonged reading may bring out people’s dry eye symptoms, and some activities, such as driving and using the computer,
- environmental elements, such as:
- reduced humidity
- air conditioning
- systemic conditions, such as:
- particular medications, including:
During a physical examination, doctors may assess individuals with dermatochalasis for anatomical risk factors, such as lid laxity and incomplete eye closure.
They may also perform tests, such as Schirmer’s test, to determine whether a person has dry eyes.
Surgeons aim to prevent dry eye syndrome in patients by observing measures to protect eye structures, such as the cornea, tear gland, and eye muscle.
Completing a proper evaluation and selecting the most suitable operation methods are also important. Controlling the inflammation can reduce trauma to the eye, which can cause dry eye.
After surgery, the surgical team aims to stave off swelling, infection, and inflammation and ensure that the eye has adequate lubrication.
Applying a cold compress around the eye and elevating the head reduces swelling. Individuals can also use artificial tears during waking hours and lubricants before sleep time.
Some people may consider nonsurgical alternatives for blepharoplasty, especially those with milder signs of aging. Alternative treatments may include:
- Injectable dermal fillers: Also called nonsurgical blepharoplasty, injectable fillers can fill deep tear troughs and lower eyelid hollows. Fillers can also subtly lift the eyebrows.
- Thermage: This treatment uses radiofrequency to stimulate collagen production, which helps tighten and smoothen the skin on the eyelids or underneath the eyes.
- Skin resurfacing: This includes a variety of treatments, such as microneedling, chemical peeling, and laser skin resurfacing, which can soften fine lines and reduce folds and wrinkles near the eye.
- Ultherapy: Ultherapy uses ultrasound to stimulate collagen production to help firm up or tighten the skin. Lifting the eyebrows through ultherapy may help lessen eyelid sagging.
- Botox: A Botox injection relaxes muscles to reduce laugh lines, or crow’s feet, and slightly lifts the eyebrows.
Treatment for dry eye depends on its cause and aims to maintain or restore the eye’s normal tears. Treatment helps maintain eye health, reduce discomfort, and prevent adverse effects on vision.
People can try the following to treat dry eyes:
The most common treatment for mild cases of dry eyes is the use of over-the-counter eye drops, gels, and lubricants to supplement a person’s natural tear production.
Increase tear production
Eye doctors can prescribe medicines, such as cyclosporine, to make the eye produce more tears.
The American Academy of Ophthalmology states that taking omega-3 fatty acids may also help soothe dry eyes.
Blocking tear ducts through plugs, which medical professionals call punctal plugs, or closing them through surgery can help prevent tear drainage, ensuring that tears stay longer in the eyes.
Prevent the loss of tears
An individual can also make lifestyle and other changes to prevent dry eyes, such as quitting smoking and avoiding windy, dry, or air-conditioned places, if possible.
People can help prevent dry eyes from developing or worsening by:
Dermatochalasis, or excess skin in the eyelids, may cause aesthetic and functional problems, such as blocked vision and dry eyes. Blepharoplasty, which is a standard treatment for dermatochalasis, may also lead to or worsen dry eyes.
People can take preventive measures to reduce the likelihood of dry eye syndrome. They may also opt for alternatives to blepharoplasty that may help reduce sagging eyelids without causing dry eyes.