Oculoplastic approach to treating Barber-Say syndrome

Barber-Say syndrome is a rare dysmorphic disorder with prominent facial involvement. Its primary features include skin, hair, and eyelid abnormalities, the last of which can cause significant ocular symptoms. This report describes a patient with symptomatic corneal exposure secondary to Barber-Say syndrome who benefited from surgical intervention. The patient underwent a bilateral mid-face lift, eyelid repositioning and reconstruction, botulinum toxin application, and acellular dermis grafting. Surgical exploration revealed dysfunctional features of the external and internal eyelid anatomy not previously described with this condition. Improvement was noted in overall facial symmetry and appearance. In addition, the patient noted increased comfort after the resolution of dry eye symptoms and exposure keratopathy.