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Updated: May 31, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
A review of surgical techniques to correct upper eyelid retraction associated with thyroid eye disease
Michael Kazim1, Katherine G Gold
1Department of Ophthalmology, Division of Ophthalmic Plastic and Reconstructive Surgery, Columbia University College of Physicians and Surgeons, New York, New York, USA. mk48@columbia.edu
Purpose Of Review:
We review the literature pertinent to surgical correction of upper eyelid retraction resulting from thyroid eye disease (TED).
Recent Findings:
Although novel nonsurgical treatment of TED-upper eyelid retraction has been described, with botulinum A toxin and hyaluronic acid; graded full-thickness blepharotomy remains the mainstay of treatment for the condition.
Summary:
Graded full-thickness anterior blepharotomy provides predictable, reproducible results and is a simple surgical procedure to master. For patients who cannot undergo surgical intervention, botulinum toxin offers a novel nonsurgical answer to lid retraction, but may be complicated by overcorrection and introduces an additional variable that needs to be considered when following the patient.

