Document Detail

Upper-eyelid wick syndrome: association of upper-eyelid dermatochalasis and tearing.
MedLine Citation:
PMID:  22893070     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To highlight a case series of patients manifesting epiphora and misdirection of tears laterally or along the upper-eyelid skin crease. This association has been termed upper-eyelid wick syndrome. We describe the clinical features and outcomes of management of these patients.
METHODS: A retrospective review of patients referred to 2 oculoplastic centers during a 6-year period for epiphora, who were considered to have misdirection of tears related in some way to upper-eyelid dermatochalasis.
RESULTS: Nine patients (7 women and 2 men; mean [SD] age, 61.2 [11.3] years, range, 41-76 years) with bilateral epiphora and lateral spillover (100%), occasionally combined with upper-eyelid wetting (n = 2). All patients had upper-eyelid dermatochalasis. Five patients had upper-eyelid skin obscuring and in contact with the lateral canthus (type 1), and in 4 the lateral canthus was only partially obscured by upper-eyelid skin (type 2). Five patients (56%) had linear excoriation of skin in the lateral canthus. All patients underwent upper-eyelid blepharoplasty, 3 combined with ptosis repair and 3 combined with eyebrow-lift. All patients achieved 80% to 100% improvement in epiphora following surgical intervention to the upper eyelid. The mean (range) follow-up was 2.8 (1-6) years.
CONCLUSIONS: We defined upper-eyelid wick syndrome as the misdirection of tears laterally or along the upper-eyelid skin crease causing epiphora, related in some way to upper-eyelid dermatochalasis. In all cases, epiphora improved with treatment of upper-eyelid dermatochalasis. Although recognized among physicians, this has never been formally described in the ophthalmic literature, to our knowledge.
Inbal Avisar; Jonathan H Norris; Dinesh Selva; Raman Malhotra
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of ophthalmology     Volume:  130     ISSN:  1538-3601     ISO Abbreviation:  Arch. Ophthalmol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-15     Completed Date:  2012-10-30     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  7706534     Medline TA:  Arch Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1007-12     Citation Subset:  AIM; IM    
Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, England, UK.
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MeSH Terms
Eyelid Diseases / complications*,  surgery
Lacrimal Apparatus Diseases / etiology*,  metabolism
Middle Aged
Retrospective Studies
Skin Diseases / complications*,  surgery
Tears / metabolism*

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