Epiblepharon. An important and often missed diagnosis

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Eyelid Anatomy

Background:

• Epiblepharon is a frequent, yet often overlooked, cause of epiphora (tearing) and ocular irritation in pediatric patients.
• This condition involves an additional fold of eyelid skin and orbicularis muscle that covers the eyelid margin.
• This fold can cause trichiasis (eyelash misdirection) by directing lashes towards the cornea, particularly during downward gaze.

Purpose of the Study:

• To illustrate the clinical presentation of epiblepharon in children.
• To emphasize the importance of examining the eyelid margin in downgaze for diagnosing epiphora and conjunctivitis in pediatric cases.

Main Methods:

• Clinical observation and photographic illustration of epiblepharon cases.
• Emphasis on specific examination techniques, including assessment during downgaze.

Main Results:

• Epiblepharon is characterized by a redundant eyelid fold.
• This fold can lead to mechanical irritation of the cornea due to aberrant lash positioning.
• The condition is often underdiagnosed without specific examination maneuvers.

Conclusions:

• Epiblepharon is a significant cause of epiphora and ocular irritation in children.
• A thorough eyelid margin examination, especially in downgaze, is essential for identifying epiblepharon.
• Early recognition and diagnosis can prevent chronic ocular discomfort and potential corneal complications.