title: Pachydermoperiostosis: a rare cause of marked blepharoptosis and floppy eyelid syndrome.
abstract: A 34-year-old African-American man was referred for eyelid swelling and ocular discomfort. He was found to have floppy hypertrophic eyelids and marked bilateral mechanical ptosis that was present since childhood. Systemic examination was significant for furrows on his forehead and scalp, coarse facial features, and enlarged hands and feet with clubbing of the fingers and toes. Radiographic imaging of the long bones demonstrated periostosis, and MRI of the head revealed a pituitary macroadenoma. Pituitary and thyroid hormone levels were normal. The patient was diagnosed with pachydermoperiostosis and a non-secreting pituitary macroadenoma. Bilateral upper lid tightening via wedge resection was followed by bilateral external levator advancement ptosis repair in a staged manner. The patient achieved symptom relief and improved lid position postoperatively.
authors.affiliation: Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Berdia
authors.forename: Frank F
authors.initials: FF
authors.lastname: Tsai
authors.forename: Jiancong
authors.initials: J
authors.lastname: Liang
authors.forename: Roman
authors.initials: R
authors.lastname: Shinder
mesh_terms: D000328:Adult; D019882:Blepharoplasty / Q000379:methods*; D001763:Blepharoptosis / Q000209:etiology* / Q000601:surgery*; D003937:Diagnosis, Differential; D005141:Eyelid Diseases / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010004:Osteoarthropathy, Primary Hypertrophic / Q000150:complications* / Q000175:diagnosis*