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Epiblepharon in a Case of Anterior Megalophthalmos: A Diagnostic Red Herring
Akshay G Nair1, Prachi M Agashe2, Ashish Doshi3
1Ophthalmic Plastic Surgery and Ocular Oncology, Advanced Eye Hospital and Institute, Navi Mumbai, IND.
Insights
Epiblepharon, a skin fold near the eyelid, rarely needs treatment. This case highlights how surgery for epiblepharon resolved symptoms initially misdiagnosed as congenital glaucoma in a child with anterior megalophthalmos.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Epiblepharon is a congenital eyelid condition typically requiring no intervention.
- Congenital glaucoma can present with similar symptoms to anterior megalophthalmos, including enlarged eyes, tearing, and photophobia.
Observation:
- A five-month-old infant presented with enlarged eyes, tearing, and photophobia, initially suspected as congenital glaucoma.
- The absence of optic disc cupping and elevated intraocular pressure, coupled with a deep anterior chamber, suggested anterior megalophthalmos.
Findings:
- The infant was diagnosed with anterior megalophthalmos and bilateral epiblepharon.
- Surgical correction of the epiblepharon led to the resolution of tearing and photophobia.
Implications:
- This case underscores the importance of considering anterior megalophthalmos in infants with symptoms mimicking congenital glaucoma.
- It highlights the potential causal link between an enlarged globe (anterior megalophthalmos) and epiblepharon, and the successful management of associated symptoms through surgical intervention.
Abstract:
Epiblepharon is a condition characterized by the presence of a congenital horizontal fold of skin near the upper or lower eyelid margin and rarely requires intervention. In this communication, we present the case of a five-month-old child who had enlarged eyes, tearing, and intense photophobia; and was referred to as a case of congenital glaucoma. Congenital or infantile glaucoma can, indeed present with enlarged eyes, watering, and photophobia. However, in the absence of optic disc cupping and elevated intraocular pressures, a diagnosis of anterior megalophthalmos should be considered, especially in the presence of a very deep anterior chamber. Subsequent evaluation in our case established the diagnosis of anterior megalophthalmos along with concomitant bilateral epiblepharon. The child underwent surgery to correct the epiblepharon, following which, the tearing and photophobia resolved. The clinical characteristics of anterior megalophthalmos and the causality between an enlarged globe and epiblepharon are discussed in this article.
