Prevalence of eyelid diseases among adults in Hong Kong


  • Shiu Ting Mak Department of Ophthalmology, United Christian Hospital, Hong Kong
  • Jeremy John Sze Wai Kwok Department of Ophthalmology, Grantham Hospital, Hong Kong
  • Hunter KL Yuen Hong Kong Eye Hospital, Hong Kong


Blepharitis, Ectropion, Entropion, Eyelid diseases, Eyelid neoplasms


Introduction: Eyelid diseases affect visual function and quality of life. This is the first study to investigate the prevalence of eyelid diseases among the general population in Hong Kong.

Methods: On 22 October 2017, The College of Ophthalmologists of Hong Kong and The Hong Kong Ophthalmological Society jointly organized a Public Education Day. A total of 165 participants were re- cruited for eyelid disease screening. Eyelid examination was performed by ophthalmology residents under the supervision of a specialist subspecializing in oculoplas- tics to identify any eyelid diseases (dermatochalasis, ptosis, entropion, ectropion, lash misdirection, presence of eyelid masses, and blepharitis). The prevalence of these eyelid diseases and their association with age and sex were determined.

Results: The 165 participants (122 females and 43 males) were all Chinese and were aged 24 to 92 (mean, 68) years; 23.6% were <60 years old, 62.4% were 60- 80 years old, and 13.9% were >80 years old. The most common eyelid disease was dermatochalasis, with a prevalence of 61.8%, followed by blepharitis (32.1%), ptosis (7.3%), and eyelid mass (6.7%). Lash misdirec- tion, entropion, and ectropion were uncommon, with a prevalence of 2.4%, 0.6%, and 0%, respectively. Dermatochalasis was more common with increasing age. Other eyelid diseases did not correlate with age.

Conclusion: Eyelid diseases are not uncommon among the general population in Hong Kong, particularly dermatochalasis, ptosis, and blepharitis. Eyelid diseases may negatively impact patients functionally and psy- chosocially. Clinicians and the general public should be aware of these eyelid diseases.


Battu VK, Meyer DR, Wobig JL. Improvement in subjective visual function and quality of life outcome measures after blepharoptosis surgery. Am J Ophthalmol 1996;121:677-86.

Federici TJ, Meyer DR, Lininger LL. Correlation of the visionrelated functional impairment associated with blepharoptosis and the impact of blepharoptosis surgery. Ophthalmology 1999;106:1705-12.

Warwar RE, Bullock JD, Markert RJ, Marciniszyn SL, Bienenfeld DG. Social implications of blepharoptosis and dermatochalasis. Ophthalmic Plast Reconstr Surg 2001;17:234-40.

Smith HB, Jyothi SB, Mahroo OA, et al. Patient-reported benefit from oculoplastic surgery. Eye (Lond) 2012;26:1418-23.

Mitchell P, Hinchcliffe P, Wang JJ, Rochtchina E, Foran S. Prevalence and associations with ectropion in an older population: the Blue Mountains Eye Study. Clin Exp Ophthalmol 2001;29:108-10.

Damasceno RW, Osaki MH, Dantas PE, Belfort R Jr. Involutional entropion and ectropion of the lower eyelid: prevalence and associated risk factors in the elderly population. Ophthal Plast Reconstr Surg 2011;27:317-20.

Jacobs LC, Liu F, Bleyen I, et al. Intrinsic and extrinsic risk factors for sagging eyelids. JAMA Dermatol 2014;150:836-43.

Şahlı E, Hoşal BM, Zilelioğlu G, Dinçer N, Tezel GG. The role of apoptosis in blepharoptosis. Eye (Lond) 2013;27:823-7.

Hofman A, Darwish Murad S, van Duijn CM, et al. The Rotterdam Study: 2014 objectives and design update. Eur J Epidemiol 2013;28:889-926.

Guinot C, Malvy DJ, Ambroisine L, et al. Relative contribution of intrinsic vs extrinsic factors to skin aging as determined by a validated skin age score. Arch Dermatol 2002;138:1454-60.

Bullock JD, Warwar RE, Bienenfeld DG, Marciniszyn SL, Markert RJ. Psychosocial implications of blepharoptosis and dermatochalasis. Trans Am Ophthalmol Soc 2001;99:65-72.

Cahill KV, Bradley EA, Meyer DR, et al. Functional indications for upper eyelid ptosis and blepharoplasty surgery: a report by the American Academy of Ophthalmology. Ophthalmology 2011;118:2510-7.

Roh KK, Lee JH, Youn DH. Clinical analysis of tumors of the eye and its adnexa. Korean J Ophthalmol 1988;2:27-31.

Lee SB, Saw SM, Au Eong KG, et al. Incidence of eyelid cancers in Singapore from 1968 to 1995. Br J Ophthalmol 1999;83:595-7.

Paavilainen V, Tuominen J, Pukkala E, Saari KM. Basal cell carcinoma of the eyelid in Finland during 1953-97. Acta Ophthalmol Scand 2005;83:215-20.

Lin HY, Cheng CY, Hsu WM, Kao WH, Chou P. Incidence of eyelid cancers in Taiwan: a 21-year review. Ophthalmology 2006;113:2101-7.

Mak ST, Wong AC, Io IY, Tse RK. Malignant eyelid tumors in Hong Kong 1997-2009. Jpn J Ophthalmol 2011;55:681-5.

Rim TH, Kang MJ, Choi M, Seo KY, Kim SS. Ten-year incidence and prevalence of clinically diagnosed blepharitis in South Korea: a nationwide population-based cohort study. Clin Exp Ophthalmol 2017;45:448-54.

Smolin G, Okumoto M. Staphylococcal blepharitis. Arch Ophthalmol 1977;95:812-6.

Chiang CC, Lin CL, Tsai YY, Peng CL, Liao YT, Sung FC. Patients with blepharitis are at elevated risk of anxiety and depression. PLoS One 2013;8:e83335.

Milner MS, Beckman KA, Luchs JI, et al. Dysfunctional tear syndrome: dry eye disease and associated tear film disorders - new strategies for diagnosis and treatment. Curr Opin Ophthalmol 2017;27(Suppl 1):3-47.

Sung J, Wang MTM, Lee SH, et al. Randomized doublemasked trial of eyelid cleansing treatments for blepharitis. Ocul Surf 2018;16:77-83.

Pereira MG, Rodrigues MA, Rodrigues SA. Eyelid entropion. Semin Ophthalmol 2010;25:52-8.

Burton M, Habtamu E, Ho D, Gower EW. Interventions for trachoma trichiasis. Cochrane Database Syst Rev 2015;11:CD004008.

Kaliki S, Ayyar A, Dave TV, Ali MJ, Mishra DK, Naik MN. Sebaceous gland carcinoma of the eyelid: clinicopathological features and outcome in Asian Indians. Eye (Lond) 2015;29:958-63.

Saleh GM, Athanasiadis I, Collin JR. Training and oculoplastics: past, present and future. Orbit 2013;32:111-6.




How to Cite

Mak ST, Kwok JJSW, Yuen HK. Prevalence of eyelid diseases among adults in Hong Kong. Hong Kong J Ophthalmol [Internet]. 2018Sep.1 [cited 2024Apr.13];22(1):18-21. Available from:



Original Articles

Most read articles by the same author(s)