title: Clicking Eyelids: A New Finding of Prostaglandin-Associated Periorbitopathy.
abstract: To present and discuss a case representing both a new sign and symptom of prostaglandin-associated periorbitopathy.
  
  
  
  An 83-year-old female patient presented for a 6-month glaucoma follow-up in July 2013 with no specific visual or comfort complaints. The patient had a 14-year history of bilateral primary open angle glaucoma and a 13-year history of once daily bimatoprost use in both eyes. Evaluation at previous examinations revealed long eyelashes, tight eyelids, small palpebral fissures, and deepening of the upper eyelid sulcus. During slit-lamp examination of the anterior segment, it was noted that the patient's eyelids clicked intermittently when she blinked. The patient had not previously noticed the clicking and it was determined to be present in each eye individually. The eyelid clicking has been noted to be present in every follow-up examination since it was discovered in July 2013.
  
  
  
  Prostaglandin-associated periorbitopathy and the resulting cosmetic effects noticed visually by patients are well documented. Our case represents a new audible sign and symptom that may be found with prostaglandin-associated periorbitopathy but has not to our knowledge been reported in the literature.
authors.affiliation: *OD, DO, MS, FAAO †OD Department of Ophthalmology, Mayo Clinic Health System, Albert Lea, Minnesota (LS, Jr.); and VA Puget Sound Health Care System, American Lake Division, Tacoma, Washington (KD).
authors.forename: Leonid
authors.initials: L
authors.lastname: Skorin
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Dailey
mesh_terms: D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects*; D000069580:Bimatoprost / Q000009:adverse effects*; D005141:Eyelid Diseases / Q000139:chemically induced*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D009916:Orbital Diseases / Q000139:chemically induced*
chemical_list: D000959:Antihypertensive Agents; D000069580:Bimatoprost