Association Between Head Tilt and Asymmetric Epiblepharon

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus

Background:

• Epiblepharon, an eyelid malposition, is typically bilateral and symmetric.
• Asymmetric epiblepharon has been observed in patients with head tilt but remains understudied.

Observation:

• This study retrospectively reviewed 1074 Korean children diagnosed with epiblepharon.
• Head tilt was present in 3.5% of patients, with superior oblique palsy and congenital muscular torticollis being common causes.

Findings:

• Asymmetric epiblepharon occurred significantly more often in children with head tilt (89.5%) compared to those without (7.7%).
• In patients with head tilt and asymmetric epiblepharon, the more severe side of the condition consistently aligned with the direction of head tilt (85.3%).

Implications:

• The findings suggest a strong association between head tilt and asymmetric epiblepharon in pediatric patients.
• Clinical evaluation for head tilt should be considered in children presenting with asymmetric epiblepharon to identify underlying causes and guide management.