Introduction to age-related eyelid skin laxity

  Laxity of the eyelid skin is an age-related change that is most often seen in older adults and also in some middle-aged people. Its prevalence is high and it is very common in life. If it occurs on the upper eyelid, it is characterized by excess, loose skin on the upper eyelid, with many folds and thick, loose skin that hangs downward, even over the lid margin, which is located roughly at the base of the eyelashes, causing the lid fissure to shrink and distort and the eyes to become smaller, with a “triangular” lid fissure, or “triangle This can cause pseudo or real ptosis, which can block the visual axis and make you feel that your field of vision is narrowed when you look at objects.  Pseudophakic ptosis is a condition in which the upper lid skin is loose and obscures part of the lid fissure and even the visual field, but when the upper lid skin is lifted, the original height of the lid fissure is displayed. In contrast, true ptosis is a condition in which some patients with severe skin laxity have increased upper eyelid weight, causing the upper lid to obscure more than 2 mm of the upper black eye cornea, which may obscure part or even all of the pupil, making the patient’s vision very fatigued.  Some patients with lax eyelid skin will also often experience a foreign body sensation. Why? It turns out that when eyelid skin laxity is significant, it can cause the eyelashes to sag as well, resulting in eyelid skin entropion and ingrown eyelashes, which can cause discomfort in the eyes, severe tearing, stinging, conjunctivitis, keratitis, and vision loss.  When eyelid skin laxity occurs in the lower eyelid, the lower lid skin is loose and the lower lid is full, forming bags.  Some patients with eyelid skin laxity also have a drooping eyebrow, which is caused by age-related changes that loosen the connection between the fat pad of the eyebrow and the frontalis muscle below it. The “triangle eye” is also caused by the downward displacement of the upper lid skin.