title: Eyelid aging: pathophysiology and clinical management.
abstract: Life expectancy is increasing in most countries. With increasing age, many individuals may develop involutional ophthalmic diseases, such as eyelid aging. Dermatochalasis, ptosis, ectropion, and entropion are common disorders in middle-aged and older adults. This review outlines the pathophysiology and clinical management of these involutional eyelid disorders. Recently, a decrease in elastic fibers with ultrastructural abnormalities and an overexpression of elastin-degrading enzymes have been demonstrated in involutional ectropion and entropion. This may be the consequence of local ischemia, inflammation, and/or chronic mechanical stress. Eyelid aging with progressive loss of tone and laxity may affect the ocular surface and adnexal tissues, resulting in different clinical symptoms and signs. Surgical management depends on the appropriate correction of the underlying anatomical defect.
authors.affiliation: Universidade Estadual de Ciências da Saúde de Alagoas, Maceió, AL, BR.
authors.forename: Renato Wendell
authors.initials: RW
authors.lastname: Damasceno
authors.affiliation: Department of Ophthalmology, University of Cologne, Cologne, DE.
authors.forename: Georgia
authors.initials: G
authors.lastname: Avgitidou
authors.affiliation: Department of Ophthalmology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Rubens
authors.initials: R
authors.lastname: Belfort
authors.affiliation: Department of Ophthalmology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, BR.
authors.forename: Paulo Elias Correa
authors.initials: PE
authors.lastname: Dantas
authors.affiliation: Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen, DE.
authors.forename: Leonard M
authors.initials: LM
authors.lastname: Holbach
authors.affiliation: Department of Ophthalmology, University of Cologne, Cologne, DE.
authors.forename: Ludwig M
authors.initials: LM
authors.lastname: Heindl
mesh_terms: D004547:Elastic Tissue / Q000503:physiopathology; D004549:Elastin / Q000502:physiology; D005141:Eyelid Diseases / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D005143:Eyelids / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D015595:Skin Aging / Q000502:physiology*
chemical_list: D004549:Elastin