Epiblepharon is a congenital eyelid malformation in which an excess skin fold and a strengthened eyelid muscle push the eyelashes inward against the eye. The lower eyelid is usually affected. Epiblepharon is particularly common in children of East Asian descent but also occurs in children of other ethnicities.
In epiblepharon, an extra skin and muscle fold at the eyelid margin pushes the eyelash row upward and inward. Unlike entropion (in which the entire eyelid turns inward), the eyelid position itself remains normal in epiblepharon. Only the eyelashes are redirected.
The inward-directed eyelashes rub on the cornea and conjunctiva, which can lead to the following symptoms:
Some children show surprisingly few symptoms despite noticeably inward-turned eyelashes because their lashes are softer than those of adults.
The diagnosis is made during the ophthalmological examination:
In many cases, epiblepharon resolves on its own as the child grows. Over the first years of life, the facial anatomy changes - the cheeks become narrower, the nasal bridge becomes higher - so that the excess skin fold at the eyelid recedes and the eyelashes assume their natural outward direction.
Surgery is recommended when:
In the surgical procedure, the excess skin and muscle fold at the eyelid margin is removed and the eyelashes are brought into a natural position. The surgery is performed under general anesthesia and usually leaves an inconspicuous scar in the eyelid area. The success rate is high.