Steatoblepharon: Causes, Symptoms, Daignosis, Prevention and Treatment

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Steatoblepharon
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Steatoblepharon

• Steatoblepharon is an anterior prolapse of
  eyelid fat pad, because of weakening of orbital
  septum, resulting in a puffy appearance of the
  eyes. The eyelid fat pads play an important role
  in maintaining contour of eyelids.Eyelid fat
  provides fullness and smoothness to both upper
  and lower eyelids. Instead of prolapse, atrophy
  of eyelid fat may cause posterior sinking of
  eyelids resulting in involutional
  enophthalmos.The upper eyelid contains two fat
  pads which are located in medial and central
  compartment. The lower eyelid contains three fat
  pads located in medial, central and lateral
  compartments.In younger individuals,
  steatoblepharon may be seen as a familial
  condition. But in most of the cases, it is seen
  as an involutional phenomenon associated with
  eyelid laxity or dermatochalasis.

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Causes of Steatoblepharon

• Steatoblepharon may be a familial condition in
  younger individuals, and is not associated with
  signs of ageing.In most cases, steatoblepharon
  is due to involutional process, associated with
  laxity of eyelids or dermatochalasis.Excessive
  steatoblepharon may be associated with systemic
  disease such as Graves ophthalmopathy, where fat
  is increased in volume and may also be
  oedematous.

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Diagnosis of Steatoblepharon

• The medial fat pocket is typically most
  prominent in the upper eyelid. Bulging in the
  lateral part of upper lid is primarily due to
  prolapsed lacrimal gland.Steatoblepharon
  usually is associated with dermatochalasis and
  may be obscured by overhanging skin fold in upper
  eyelid.In the lower eyelid, fat may be
  prolapsed in any of the three compartments. There
  may be two fat pockets or even one contiguous
  pocket. The lateral fat pocket is typically most
  prominent, but fat prolapse may involve medial
  and central fat pockets with a bulge across
  entire lower eyelid.

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Treatment of Steatoblepharon

• Management is primarily surgical. It is often
  combined with blepharoplasty.Orbital septum may
  be tightened for mild fat prolapse. For
  significant degrees of fat prolapse, orbital
  septum is opened and fat pocket is cauterized
  excised.In lower eyelid steatoblepharon without
  dermatochalasis, fat pockets are removed through
  a trans-conjunctival incision, without disturbing
  the orbital septum.In cases with excess skin in
  lower eyelid, a trans-cutaneous incision is
  preferred, and the skin is tightened laterally.
  Repositioning of fat beneath the descended malar
  fat pad may also be done.

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