Abstract Listings 2025

Purpose

To describe the clinical course and ophthalmological findings in a patient with pachydermoperiostosis (PDP) who developed ocular surface symptoms after surgical correction of eyelid hypertrophy.

Methods

This case report details the clinical history, systemic examination, and comprehensive ophthalmological assessment of a patient with known history of PDP.

Results

A 37-year-old male patient, with a history of complete PDP, had previously undergone bilateral upper and lower full-thickness partial resection of tarsal hypertrophic tissues for severe blepharoptosis, resulting in initial improvement. He presented one year later with ocular burning and redness. Examination revealed characteristic systemic features including coarse, thickened facial skin, deeply furrowed forehead, cutis verticis gyrata, enlarged hands and clubbed fingers. Ophthalmological assessment showed hypertrophic, thickened eyelids with evidence of partial surgical excision. Severe bilateral upper and lower ectropion, lagophthalmos, marked Meibomian gland dysfunction, diffuse conjunctival hyperemia, and superficial punctate keratitis were present. Best-corrected visual acuity was 20/25 in both eyes, with unremarkable anterior segments and normal posterior segment findings.

Conclusion

PDP is a rare genetic disorder that primarily affects the skin and the skeletal system. Ocular involvement is uncommon, with blepharoptosis being the most frequently reported finding. This case underscores the challenges of managing progressive eyelid changes in PDP. Despite previous surgical debulking, continued tissue hypertrophy led to secondary complications, including ectropion, Meibomian gland dysfunction and exposure keratopathy. These changes contributed to significant ocular surface disease. Effective management requires a comprehensive approach that addresses both the mechanical eyelid abnormalities and the resulting ocular surface inflammation and exposure-related damage

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