Ocular Surface Alterations in Eyelid Malpositions: Pathophysiology, Diagnostic Tools, and Therapeutic Approaches

Dear Colleagues,

Eyelid malpositions, including entropion, ectropion, eyelid retraction and ptosis, and lagophthalmos, significantly compromise the anatomy and function of the ocular surface and are frequently encountered in ophthalmology practice. These alterations can lead to exposure, tear film instability, inflammation, and chronic epithelial damage, ultimately compromising visual function and quality of life.

This Special Issue will explore the multifactorial pathophysiological mechanisms linking eyelid abnormalities with ocular surface diseases. It will highlight the role of mechanical, inflammatory, and neurogenic factors in the development of dry eye, conjunctival metaplasia, and corneal damage. It will also discuss advances in diagnostic imaging, such as meibography, anterior segment OCT, tear film interferometry, and MS-39 OCT as tools in better assessing structural and functional changes.

We will review therapeutic strategies, both medical and surgical, with a focus on personalized and evidence-based management. These include the employment of conservative lubrication, immunomodulatory therapy, eyelid surgery, and innovative techniques such as lipofilling or gold weight implantation to restore eyelid positioning and function.

For this Special Issue, we invite clinicians, surgeons, and researchers to contribute toward enhancing our current understanding of the interaction between eyelid mechanics and ocular surface integrity, with the aim of optimizing patient outcomes through integrated diagnosis and treatment.

Topics of interest include (but are not limited to) the following:

• The pathophysiology of ocular surface disorders in lid malpositions;
• Diagnostic imaging and tear film analysis in patients with lid malpositions (OCT, meibography, impression cytology, etc.);
• The clinical correlation between lid malpositions and dry eye syndrome;
• The role of inflammation and molecular biomarkers;
• Oculoplastic surgical techniques and their impact on ocular surface rehabilitation;
• Multidisciplinary approaches to periocular reconstruction and surface stabilization;
• Long-term outcomes in surface recovery after lid surgery;
• Case reports and rare presentations involving complex lid malpositions and surface compromise.

Intended audience:

This Special Issue will provide an invaluable resource for ophthalmologists, oculoplastic surgeons, and cornea and ocular surface specialists, as well as clinicians and researchers involved in diagnostic imaging, tear film analysis, and periocular pathology.

Dr. Massimiliano Serafino
Dr. Alessandra Di Maria
Guest Editors

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• lid malpositions and ocular surface disorders
• dry eye syndrome
• exposure keratopathy
• tear film instability
• anterior segment imaging
• lid surgery outcomes