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Surgical Correction for Pediatric Epiblepharon and Trichiasis

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Published on: July 8, 2025

Thyroid Eye Disease-Related Epiblepharon: A Comparative Case Study.

Jiawei Zhao¹, Nickisa M Hodgson¹, Jessica R Chang^1,2

¹Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.)

|January 29, 2020

Summary

Lower eyelid epiblepharon, a condition associated with thyroid eye disease (TED), is more common in younger Asian patients. Surgical correction, including lateral canthoplasty, proved effective for these TED patients.

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Area of Science:

Ophthalmology
Endocrinology
Genetics

Background:

Thyroid eye disease (TED) is an autoimmune condition affecting the orbit.
Epiblepharon is an eyelid malformation characterized by redundant skin causing the eyelid margin to roll inward.
The association between TED and epiblepharon, particularly in specific ethnic groups, requires further investigation.

Observation:

A retrospective review of 172 adult patients with TED identified 3 cases of acquired epiblepharon.
All identified patients with epiblepharon were of Asian descent.
Patients with epiblepharon were significantly younger than those without the condition.

Findings:

The prevalence of epiblepharon in Asian patients with TED was significantly higher (17.6%) compared to non-Asian patients (0%).

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Patients diagnosed with epiblepharon had a mean age of 29.7 years, contrasting with the mean age of 48.7 years for those without epiblepharon.

Surgical correction involving lateral canthoplasty and anterior lamellar pretarsal fixation yielded successful outcomes in all affected patients.

Implications:

Lower eyelid epiblepharon may be a specific manifestation of TED, particularly in Asian and younger populations.
Understanding the demographic predilection can aid in early diagnosis and management of TED-associated epiblepharon.
Surgical intervention focusing on horizontal tension relief and anterior lamellar fixation is an effective treatment strategy.