Blepharophimosis is an ophthalmic syndrome, manifested by bilateral ptosis in combination with a decrease in the vertical and horizontal size of the eyelids. The main symptoms; pathological section of the eyes, increased fatigue in performing visual work, impaired vision, disruption of accommodation. For the diagnosis is used physical examination, ultrasound of the eye, biomicroscopy, visometry, contactless tonometry. Tactics of treatment is reduced to an operative multi-stage reconstruction of the eyelids, including cantoplasty followed by correction of ptosis.
Blepharophimosis is one of the forms of dysplasia of the eyelids, first described in 1889 by the French ophthalmologist Vinem. In 55% of cases, sporadic forms of pathology are observed. Identify genetic mutations or establish a hereditary predisposition with the help of the genealogical method is possible only in 45% of patients. Men and women suffer from the same frequency. The disease is more often diagnosed among residents of North, East and South-East Asia, which is due to national features of appearance. There is no statistical data on the total prevalence of blepharophimosis in ophthalmology.
The first symptoms of the disease are detected in the neonatal period. Parents pay attention to the unusual cut of the child’s eyes. The eye gap is not only excessively narrow, but also shortened. The deformation of the medial angle of the eye is visualized. In patients, nedorazvitie nose is defined. The distance between the right and left eyeball is increased, which indicates a hypertelorism. Also, the distance between the inner corners of the eye slits is increased. A vertical fold of the skin of the semilunar form is found, located in the region of the lower eyelid. The upper eyelid is lowered. Closure of the eye gap is severely limited.
Tactics of treatment depends on the anatomical features of the eye gap and concomitant lesions, is developed individually for each patient. As a rule, patients need a multi-stage reconstruction. First of all, the correction of the telecanthus and the reverse epicanthus is shown. For this, transnasal fixation or Z-plasty is performed. Further perform cantoplasty. The purpose of surgery is to correct the incision of the eyes. After cantotomy, the canthal tendon is partially removed and the tissues of the eyelid are fixed to the period of the orbit. In the region of the incision, a cosmetic suture is applied.