Congenital eyelid imbrication syndrome: A rare occurrence in Pakistan.

Congenital eyelid imbrication syndrome (CEIS) is a rare condition presenting at birth and is characterised by overriding of the upper lid on the lower lid. It is due to longer upper lid, than the lower lid. Overriding leads to spontaneous eversion of the upper lids. In our patient, examination revealed canthal tendon laxity and hyperaemia of the tarsal conjunctiva. All the rest of the structures in the eyeball and adnexa were normal. Spontaneous eversion occurred in two weeks as the upper lid grew with time. No treatment was required.

Meibography-Guided Electroepilation for Congenital Distichiasis: A Novel Surgical Technique.

PURPOSE: Congenital distichiasis is managed either by ablation, using laser, cryotherapy, or electroepilation, or by surgical excision with mucous membrane grafting. Ablative procedures are usually blind as the exact depth of distichiatic eyelashes is unknown. The described surgical technique utilizes meibography for imaging the root and depth of distichiatic eyelashes that aided in performing electroepilation. METHODS: Six patients (n = 24 eyelids; mean age 15.5 ± 12.2 years) underwent infrared meibography (Oculus Keratograph 5 M) and noninvasive tear breakup time prospectively. Eyelashes were electroepilated using a premarked needle inserted at a depth based on meibography findings in 4 patients. Surgical success was defined as no distichiatic eyelash regrowth and functional success was defined as the resolution of symptoms at a minimum of 3 months of follow-up. RESULTS: All 6 patients had all 4 eyelids involved to varying degrees, with a total of 230 distichiatic eyelashes. The median number of distichiatic eyelashes was 9 in the upper eyelids and 4.5 in the lower eyelids. Meibography revealed visible distichiatic eyelash roots in 70% of eyelashes in the upper eyelid and 87.8% in the lower eyelid, respectively. The median eyelash root depth was 2.7 mm (mean 2.9 mm, range 1.8-5.4 mm). The mean noninvasive tear breakup time was 12.2 seconds despite absent or rudimentary meibomian gland segments seen on meibography. The anatomical success was 75% (12/16 eyelids), and functional success was 87.5% (7/8 eyes) at a median follow-up of 5.5 months. CONCLUSION: Preoperative infrared meibography in eyelids with congenital distichiasis helps estimate the eyelash depth and can be used to guide eyelash ablation procedures.

Congenital epiblepharon in Chinese school-age children: a cross-sectional study.

PURPOSE: To investigate the prevalence and body mass index (BMI) associations of congenital lower epiblepharon in children in China and the difference in the refractive errors between children with and without epiblepharon. METHODS: Children 6-12 years of age in Beichen District of Tianjin were screened for congenital epiblepharon from September to October 2017. All children underwent slit-lamp examination, strabismus screening, visual acuity examination and refraction. Weight and height were also recorded. The prevalence of lower epiblepharon in school-age children was evaluated, and its association with age, sex, BMI, and refractive error was analyzed. RESULTS: A total of 28,225 children were examined; 564 had epiblepharon. The prevalence of epiblepharon was found to be, for 6-year-olds, 2.50%; for 7-year-olds, 2.13%; for 8-year-olds, 2.10%; for 9-year-olds, 1.97%; for 10-year-olds, 1.85%; for 11-year-olds, 1.67%; and for 12-year-olds, 1.19% (P < 0.05). The prevalence of overweight and obesity in children with epiblepharon was found to be 16.7% and 47.2%, respectively. The prevalence and degree of astigmatism was higher than in nonepiblepharon children. We found a possible association between severity of astigmatism and severity of epiblepharon. CONCLUSIONS: In our study, the prevalence of epiblepharon decreased with advancing age, and the majority of children with epiblepharon were found to be overweight or obese. Epiblepharon was associated with astigmatism.

Sensory Function of Children With Strabismus After Epiblepharon Surgery.

PURPOSE: To investigate the effect of epiblepharon surgery on motor and sensory function in children with epiblepharon and concomitant strabismus. METHODS: Among 564 patients who underwent epiblepharon correction surgery from May 2016 to April 2023, 45 children who were examined for strabismus were included in the study. Preoperative and postoperative visual acuity, refraction, and angle of deviation were analyzed. For those with significant angle of deviation, additional stereopsis, sensory fusion, and returning time were retrospectively investigated. The angle of deviation was examined by one examiner at distance and near. RESULTS: The mean age of 45 children (18 boys and 27 girls) was 6.8 ± 2.9 years. Fifteen had significant strabismus at the time of epiblepharon surgery. Visual acuity improved in both the total and strabismus groups. Improvement in stereopsis and fusion was also observed in the strabismus group. The angle of deviation showed no difference in both groups. CONCLUSIONS: Epiblepharon could affect ocular manifestations of strabismus as shown in this study. The authors suggest strabismus treatment be continued after epiblepharon surgery, with improved sensory function. Further evaluation with larger groups is needed in the future. [J Pediatr Ophthalmol Strabismus. 2024;61(4):257-261.].

Congenital Eyelid Imbrication and Floppy Eyelid Syndromes Complicated by Eversion due to Prostaglandin E Infusion in a Patient With Trisomy 21 and Tetralogy of Fallot.

Congenital eyelid imbrication syndrome is a rare eyelid finding where a long upper lid overlaps the lower lid when the eyes are closed. To date, congenital eyelid imbrication syndrome has been described in the literature less than 10 times. We present a case of congenital eyelid imbrication syndrome in a patient with trisomy 21 and tetralogy of Fallot on a prostaglandin E infusion to maintain a patent ductus arteriosus prior to definitive heart surgery. While on the infusion, the patient developed peripheral edema and flushing due to vasodilation. This coincided with eyelid swelling, conjunctival chemosis, and eversion of the eyelids. Upon cessation of the prostaglandin E1 infusion, his eyelid eversion resolved.

El epicanto como rasgo fenotípico racial / Epicanthus: a racial phenotype trait

Durante el desarrollo evolutivo, el hombre ha sido el animal más perfecto en la creación de la naturaleza y como el resto de los organismos que viven en el planeta continúa en transformación. Para que ocurra este proceso son importantes las variaciones hereditarias y la selección natural como fuerzas fundamentales y, dentro de las primeras, son las mutaciones las que garantizan el primer eslabón en la variabilidad de las especies durante un proceso de miles a millones de años

Corrección de ptosis palpebral congénita con anestesia local en pacientes pediátricos / Congenital palpebral ptosis correción under local anesthesia in pediatric subjects

El presente es un estudio descriptivo basado en experiencia clínica acerca de la corrección de ptosis palpebral en pacientes pediátricos bajo anestesia local, seleccionados según criterios de inclusión específicos, cuyo objetivo es demostrar que este procedimiento, es técnicamente factible, a fin de valorar dinámicamente el grado de correción quirúrgica durante el transoperatorio. Los pacientes se someten a dos fases evaluatorias según su cooperación, tranquilidad y comprensión, las cuales son valoradas por el cirujano y el anestesiólogo a fin de obtener resultados óptimos. El estudio incluyó 11 pacientes y 13 procedimientos, siendo la edad promedio de 8 años. Se valoraron diversos parámetros, considerando a la apertura palpebral como el indicador más importante. Los resultados finales se clasificaron según la cosmesis y la simetría palpebral, obteniendo los siguiente resultados: bueno, 7 pacientes (54 por ciento); regular, 5 pacientes (39 por ciento); y malo, 1 paciente (7 por ciento). Se revisó también a un grupo de pacientes sometidos a corrección de ptosis bajo anestesia general en el mismo lapso, a fin de establecer una comparación de nuestros resultados. Nuestro trabajo constituye una alternativa en el manejo quirúrgico de estos pacientes, debido a que permite valorar la función y evita los riesgos de la anestesia general, además de que plantea la posibilidad de realizar estudios más extensos, con el fin de valorar la prevalencia de ptosis residuales con nuestra técnica y compararlos con la técnica bajo anestesia general

Nevo melanocítico congénito: una forma particular, el nevo dividido palpebral / Congenital melanocytic nevus: a particular type, split palpebral nevus

El nevo dividido palpebral (NDP) es una forma particular de nevo melanocítico congénito (NMC), que constituye un marcador biológico del período fetal en el cual se forman estos nevos. Nos induce a pensar que tiene que originarse durante o después de la fusión palpebral y antes de su aperura definitiva. En los fetos humanos, los párpados se forman entre la 5a. y 6a. semana, y comienzan a fusionarse entre la 8a. y 9a. semanas, para reabrirse durante el 6º mes de vida intrauterina. Por lo tanto, es posible que éste sea el período en el cual se forman los NMC (entre la 10a. semana y el 6º mes). Hemos tenido la oportunidad de estudiar 3 pacientes con NDP y dada la importancia biológica de los mismos y su escasa observación, nos parece de interés comunicarlos

Euribléfaro e ectrópio congênito associado à síndrome de Down / Euryblepharon and congenital ectropion associated with Down's syndrome

Euribléfaro é uma alteraçäo palpebral pouco conhecida que consiste em um aumento simétrico e bilateral das fissuras palpebrais geralmente acompanhado de ectrópio congênito. Um caráter familial pode estar ligado a esta condiçäo. Um caso de euribléfaro e ectrópio congênito das quatro palpebras associados a Síndrome de Down é descrito. As diversas hipóteses propostas para explicar o aparecimento desta anomalia säo enumeradas bem ocmo as indicaçöes de sua correçäo. Uma técnica cirúrgica que combina o implante de expansores de silicone infláveis sob a pele das pálpebras e tarsorrafia lateral foi utilizada pra corrigir o euribléfaro. O relato do caso reforça as teorias que sugerem a existência de alteraçöes estruturais nas pálpebras dos portadores de Síndrome de Down predispondo o achado de deformidades pálpebrais congênitas