{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.dermatochalasis","code":"thing-q1200233","url":"https://ver.cy/models/thing/q1200233/","name":"dermatochalasis","alternateNames":[],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Cross-cutting context","entryKind":"thing","plane":"XCT","domain":["XCT.STA"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Dermatochalasis is redundancy and laxity of eyelid skin, usually associated with ageing, that can affect the upper or lower eyelids and may cause cosmetic concerns or functional impairment.","purpose":"Enable an agent to recognise dermatochalasis, record its anatomical and functional effects, and support assessment, referral and follow-up decisions.","scope":{"in":["Loose, redundant skin affecting upper or lower eyelids","Laterality, skin-fold distribution and change over time","Separation of skin redundancy from eyelid-margin descent, brow descent and fat prominence","Symptoms and functional limitations attributable to the redundant skin","Clinical assessment, management goals and documented outcomes"],"out":["Blepharoptosis as an independently modelled eyelid-margin disorder","Brow ptosis as an independently modelled brow-position disorder","Blepharochalasis and its recurrent swelling episodes","Orbital fat prolapse, lacrimal-gland prolapse and eyelid masses as separate conditions","Detailed blepharoplasty techniques and perioperative protocols","Other ocular diseases responsible for visual impairment"],"boundaries":[]},"distinguishingFeatures":["Identify redundant eyelid skin itself; a low upper eyelid margin indicates possible coexisting blepharoptosis rather than establishing dermatochalasis.","Assess brow position separately to distinguish brow-related hooding from eyelid skin redundancy.","Distinguish persistent skin excess from a history dominated by recurrent eyelid swelling suggestive of blepharochalasis.","Separate loose skin folds from fullness attributable to protruding fat or another focal structure."],"structure":{"bundles":[{"id":"skin-redundancy-and-distribution","name":"Skin redundancy and distribution","description":"Establish whether redundant eyelid skin is present and describe where it occurs.","layers":[{"id":"defining-tissue-change","name":"Defining tissue change","description":"Separate the anatomical definition from a person's assessment status.","findings":[{"id":"redundant-eyelid-skin","name":"Redundant eyelid skin","description":"Dermatochalasis denotes loose, redundant eyelid skin and can affect upper or lower lids. [AAO EyeWiki: Dermatochalasis](https://eyewiki.aao.org/Dermatochalasis)","questions":[{"text":"What examination evidence identifies redundant skin on each affected eyelid?","id":"redundant-eyelid-skin-q01","kind":"definition"},{"text":"Who documented the finding, when, and using which examination or images?","id":"redundant-eyelid-skin-q02","kind":"provenance"}]}]},{"id":"eyelid-topography","name":"Eyelid topography","description":"Record the distribution and extent of folds under reproducible conditions.","findings":[{"id":"fold-location-and-extent","name":"Fold location and extent","description":"Describe each eyelid separately, identifying the skin edge, anatomical landmarks and observation conditions.","questions":[{"text":"Which upper or lower eyelids have medial, central, lateral or diffuse redundancy?","id":"fold-location-and-extent-q01","kind":"measurement"},{"text":"Where does the redundant skin edge lie relative to the lashes and other named landmarks with gaze and brow position documented?","id":"fold-location-and-extent-q02","kind":"measurement"}]}]}]},{"id":"anatomical-attribution-and-course","name":"Anatomical attribution and course","description":"Distinguish skin redundancy from adjacent abnormalities and document its development.","layers":[{"id":"brow-margin-and-fullness","name":"Brow, margin and fullness","description":"Assess neighbouring structures without absorbing their diagnoses into dermatochalasis.","findings":[{"id":"separate-anatomical-contributors","name":"Separate anatomical contributors","description":"Brow descent, blepharoptosis and orbital fat prominence require separate assessment and may coexist with skin redundancy. [AAO EyeWiki: Dermatochalasis](https://eyewiki.aao.org/Dermatochalasis)","questions":[{"text":"After the examiner accounts for the overhanging skin, is the upper eyelid margin independently low?","id":"separate-anatomical-contributors-q01","kind":"boundary"},{"text":"How much of the observed hooding or fullness is attributed to brow position, skin excess, fat or an unresolved structure?","id":"separate-anatomical-contributors-q02","kind":"boundary"}]}]},{"id":"onset-and-swelling-history","name":"Onset and swelling history","description":"Record the course and distinguish observed chronology from inferred cause.","findings":[{"id":"persistent-versus-episodic-change","name":"Persistent versus episodic change","description":"The record should distinguish stable or progressive skin redundancy from episodes of swelling and document prior periocular interventions.","questions":[{"text":"When was skin redundancy first noticed, and what dated evidence shows progression or stability?","id":"persistent-versus-episodic-change-q01","kind":"provenance"},{"text":"Does recurrent swelling, abrupt change or prior surgery require assessment of an additional condition before attribution is settled?","id":"persistent-versus-episodic-change-q02","kind":"boundary"}]}]}]},{"id":"functional-and-experienced-burden","name":"Functional and experienced burden","description":"Connect skin redundancy to reported concerns and assessable functional effects.","layers":[{"id":"symptoms-and-daily-activities","name":"Symptoms and daily activities","description":"Capture what the person experiences and whether an anatomical explanation has been assessed.","findings":[{"id":"burden-and-attribution","name":"Burden and attribution","description":"Reported concerns can include visual interference, heaviness, skin-fold irritation and appearance. Record each independently. [AAO EyeWiki: Dermatochalasis](https://eyewiki.aao.org/Dermatochalasis)","questions":[{"text":"Which activities or appearance concerns are affected, how often, and on which side?","id":"burden-and-attribution-q01","kind":"measurement"},{"text":"What supports attributing each concern to redundant skin rather than another ocular or periocular condition?","id":"burden-and-attribution-q02","kind":"boundary"}]}]},{"id":"functional-documentation","name":"Functional documentation","description":"Preserve the protocol and limitations of functional testing.","findings":[{"id":"supported-and-unsupported-comparison","name":"Supported and unsupported comparison","description":"Photography and visual-field testing with and without skin elevation can document functional effects. [AAO EyeWiki: Dermatochalasis](https://eyewiki.aao.org/Dermatochalasis)","questions":[{"text":"What visual-field results were obtained under unsupported and supported conditions, using which protocol and reliability criteria?","id":"supported-and-unsupported-comparison-q01","kind":"measurement"},{"text":"Did support also move the brow or eyelid margin, limiting attribution of the measured change to skin alone?","id":"supported-and-unsupported-comparison-q02","kind":"boundary"}]}]}]},{"id":"management-readiness-and-outcomes","name":"Management readiness and outcomes","description":"Record goals, assessment dependencies and outcomes of observation or intervention.","layers":[{"id":"goals-and-clinical-readiness","name":"Goals and clinical readiness","description":"Connect the desired change to the findings and the clinician's assessment.","findings":[{"id":"assessment-before-intervention","name":"Assessment before intervention","description":"Ophthalmic assessment informs management; blepharoplasty is a treatment option. The model records decisions rather than prescribing surgery. [AAO EyeWiki: Dermatochalasis](https://eyewiki.aao.org/Dermatochalasis)","questions":[{"text":"Is the person's priority visual function, comfort, appearance or a documented combination?","id":"assessment-before-intervention-q01","kind":"action"},{"text":"What ocular-surface, eyelid-closure or coexisting anatomical findings must the clinician address before selecting an intervention?","id":"assessment-before-intervention-q02","kind":"action"}]}]},{"id":"longitudinal-response","name":"Longitudinal response","description":"Compare subsequent state with baseline while accounting for concurrent procedures.","findings":[{"id":"residual-redundancy-and-goal-response","name":"Residual redundancy and goal response","description":"Track skin redundancy, reported burden and functional evidence over time, recording any concurrent brow or ptosis treatment.","questions":[{"text":"At what follow-up interval were skin appearance, symptoms and relevant functional measurements reassessed against baseline?","id":"residual-redundancy-and-goal-response-q01","kind":"measurement"},{"text":"Do persistent concerns, recurrent redundancy or new closure difficulties require reassessment, and who owns that next action?","id":"residual-redundancy-and-goal-response-q02","kind":"action"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-confidence-notes","name":"Check these first","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these check these first hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-confidence-notes-q01","kind":"provenance"}]},{"id":"evidence-kinds","name":"Kinds and varieties","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these kinds and varieties hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-identifiers","name":"Identifiers and schemes","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these identifiers and schemes hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-identifiers-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these real-world use hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-measurements","name":"Typical measurements","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these typical measurements hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-measurements-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these regional variation hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of dermatochalasis this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Explain dermatochalasis in general terms from reputable medical sources.","Suggest that a person whose drooping eyelids block vision see an eye doctor."],"mustNot":["Diagnose the condition from a person's photo.","Comment on a person's age or appearance in a demeaning way.","Recommend cosmetic surgery or promote clinics to a specific person.","Use a person's face images for marketing without consent."],"requiresHuman":["Any decision on eyelid surgery."]},"ethics":{"considerations":["Ageing is natural; pressure toward cosmetic surgery can exploit insecurity.","Functional loss of vision matters for safety and independence, such as driving."],"affectedParties":["Older adults","Drivers with reduced field of view","Cosmetic surgery patients"]},"owners":{"steward":"Nobody owns the condition; patients and their clinicians answer for care.","roles":[],"masterSystems":[]},"relations":[{"target":"Q18556729","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.dermatochalasis","Wikidata: Q1200233 (https://www.wikidata.org/wiki/Q1200233)"]},"properties":{"applicability":"not-applicable","items":["Affected eyelids: Right upper; left upper; right lower; left lower; multiple selections permitted","Skin-fold distribution: Medial; central; lateral; diffuse; unassessed, recorded per eyelid","Skin-edge position: Millimetres relative to a named anatomical landmark, with gaze and brow conditions recorded","Upper eyelid-margin position: Margin-reflex distance 1 in millimetres, with examination conditions","Neighbouring anatomical contributors: Linked assessments of brow position, blepharoptosis, fat prominence and other periocular abnormalities","Reported burden: No concern; appearance concern; heaviness; visual interference; fold irritation; other reported concern; combinations allowed","Visual-field assessment: Instrument-specific results with protocol, reliability and unsupported versus supported-skin conditions","Assessment status: Suspected; clinically documented; attribution uncertain; alternative explanation identified","Management state: Observation; assessment pending; intervention discussed; intervention planned; treated; reassessment required"]},"recognition":{"applicability":"optional","items":["Loose, folded skin of the upper or lower eyelid, often hanging over the lid crease.","Usually on both sides and more visible with age."]},"capabilities":{"applicability":"required","items":["Create an eyelid-specific record of skin redundancy with examination or photographic evidence.","Flag observations requiring separate assessment of brow ptosis, blepharoptosis or another cause of fullness.","Compare symptoms and functional measurements across documented examination conditions.","Prepare a referral summary separating anatomical findings, patient goals and unresolved attribution.","Track observation or treatment outcomes against the person's baseline concerns."]},"hazards":{"applicability":"required","items":["Excess upper lid skin can narrow the field of vision.","Unnecessary surgery carries risks such as dry eye and asymmetry."]},"interfaces":{"applicability":"required","items":["The International Classification of Diseases, Tenth Revision, Clinical Modification, maintained by the United States National Center for Health Statistics, includes dermatochalasis of the eyelid under category H02.83."]},"context":{"applicability":"required","items":["Dermatochalasis is encountered in eye care and eyelid assessment when redundant skin affects appearance, comfort or visual function.","Clinical records describe the affected eyelids and any functional effects to support assessment and follow-up."]}},"sources":[{"title":"Wikidata item Q1200233: dermatochalasis","url":"https://www.wikidata.org/wiki/Q1200233","note":"identity and sense of the item"},{"title":"Wikipedia: Dermatochalasis","url":"https://en.wikipedia.org/wiki/Dermatochalasis","note":"general description of the item"}],"openQuestions":["Which grading method provides sufficiently reproducible dermatochalasis severity assessments across eyelid anatomies and examiners?","Which functional-testing protocols best isolate the contribution of redundant skin when brow ptosis or blepharoptosis coexists?","What evidence supports attributing lower-eyelid symptoms specifically to redundant skin rather than associated eyelid or ocular-surface conditions?","Which patient-reported measures and follow-up intervals best distinguish meaningful improvement from short-term postoperative change?","How should setting-specific intervention or coverage criteria be represented without treating them as universal diagnostic thresholds?"],"resources":{"spec":"/models/things/publications/thing-q1200233/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q1200233/spec.json"],"providers":["Codex"],"researchStatus":"unreviewed","generatedAt":"2026-09-12T09:06:45Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:25+00:00: completeness 1.00; sense: Wikidata description; 2 live sources; review by codex: pass","interaction.properties":"Plane XCT: no invented physical properties."},"score":1.0}}