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Published in Chung Nen Chua, Li Wern Voon, Siddhartha Goel, Ophthalmology Fact Fixer, 2017
In epiblepharon there is excess pre-tarsal skin and orbicularis oculi. This can cause misdirection of the eyelashes, resulting in corneal irritation and punctate keratitis. Dermatochalasis is seen in the elderly due to excess upper lid skin. Overhanging of the skin can cause superior visual field defects. Blepharochalasis affects younger people with recurrent inflammation and swelling of the upper lid. This can lead to loosening of the skin and levator dehiscence. It is not caused by allergy. Floppy eyelid syndrome typically affects middle-aged overweight males. The upper lid everts easily during sleep, causing mechanical irritation. Chronic papillary conjunctivitis and punctate keratitis are common. Brow ptosis can be involutional or the result of facial nerve palsy.
Surgical management of orbital hypertelorism
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
David M Yates, Jennifer E Woerner, G E Ghali
This population pre-operatively may exhibit epiblepharon, astigmatism and exotropia.GeneticsOrthodonticDecision for box osteotomies versus facial bipartition
Effect of Congenital Lower Eyelid Epiblepharon Surgery on Asymmetric Margin Reflex Distance 1
Published in Current Eye Research, 2021
Min Kyu Yang, Namju Kim, Ho-Kyung Choung, Sang in Khwarg
Epiblepharon is a condition in which the marginal skin of the eyelid and the underlying pretarsal orbicularis muscle form a horizontal fold that pushes the eyelashes inward against the cornea.1 Acquired epiblepharon in thyroid-associated ophthalmopathy has been reported, but most cases of epiblepharon are representative of a congenital condition.1 Congenital lower eyelid epiblepharon usually involves the medial side of the lower eyelids and occurs bilaterally.1,2 Affected patients suffer from varying degrees of ocular irritation symptoms such as itching, eye rubbing, squinting, and photophobia.
A retrospective study of pediatric thyroid eye disease: the Asian experience
Published in Orbit, 2022
Bryan Sim, Chiaw Ling Chng, Chia Audrey, Lay Leng Seah
A prominent feature peculiar to Asian patients with TED was that of acquired epiblepharon which was found to be present in 11.5% of local adult patients4 and 85% (42 of 494 patients) of adult Koreans with TED19 with the prevalence of epiblepharon amongst the general Singapore population being estimated to be at 9.5%.20 Amongst the local pediatric population, our study revealed a markedly higher prevalence of acquired epiblepharon (63.2%). These patients also had concomitant symptoms of ocular irritation, epiphora and showed punctate epithelial erosions on corneal staining. Epiblepharon is defined as a horizontal fold of skin and hypertrophic pretarsal orbicularis overriding the eyelid margin, obscuring the lashes and pushing them towards the ocular surface. The eventual result is eyelashes contacting the globe and cornea, subsequently leading to keratopathy and possibly infective keratitis. It has been well established in many TED studies in Asia4,19 that epiblepharon development in TED is acquired rather than of congenital in nature and we postulate could be contributed by the following mechanisms. Lower lid retraction as seen in 63.2% of our study patients could play a role in the pathophysiology of acquired epiblepharon development. The fibrosis and shortening of the posterior lamellar results in overriding of the stable anterior lamella which results in epiblepharon development. Moreover, proptosis in TED due to elevated intraorbital pressure may lead to fat prolapse with overriding of the anterior lamellar over the posterior lamellar. Other postulated mechanisms include that of tight orbital septum and pre-existing epiblepharon or retractor abnormality. Out of the 12 patients in our study who developed acquired epiblepharon in the course of TED, 3 patients (25%) required subsequent epiblepharon repair.