Epiblepharon


Epiblepharon is a condition in which a fold of skin and or muscle (orbicularis) push onto lower eyelid leading to eyelashes touching eyes causing irritation. It commonly occurs in lower eyelid, especially in area close to the nose, but can also occur in upper eyelid too.

It usually present since birth, but can present in older ages especially when one put on weight. The traditional belief is that it can resolve with age. However, in Dr Ho’s experience, it often does not. Children seldom complain except they are noted to rub their eyes constantly. Some are afraid to see light (photophobia) and develop watery eyes. In one severe case, the child did not do well in school and was unable to read because of poor eyesight and watery eye.

Recently, studies showed that there may be some association between astigmatism with epiblepharon and surgery to correct this may be associated with positive outcome.

fold of skin causing lashes to go up

  • fold of skin causing lashes to go up

Provided Physiotherapies

Treatment

The treatment usually requires surgery. It is done under general anesthesia in children but under local anesthesia in adult. Patient can usually go home the same day.

Pre Op:  Redundant skin in upper and lower eyelid pushing eyelashes in upper eyelid downwards and eyelashes in lower eyelids upwards.

Post op:  Corrected eyelashes direction and both upper and lower eyelashes everted out.

Pre op:  similar girl with epiblepharon upper and lower eyelid leading to eyelashes poking into the eyes and sleepy look.

Post op :  A much more attractive, alerted look with lashes no longer poking into the eyes causing irritation.

Pre op:  This lady presented with persistent watery and irritation in both eyes as lashes poked into her cornea.

Post op:  everted eyelashes and upper eyelashes were everted out using double eyelids techniques.

Pre op:  This boy present with constant rubbing and watery of both eyes and image showed roll of skin in lower eyelid forcing the eyelashes to go towards the cornea.

Post op:  the fold of skin has been removed and the eyes appear wider.  Most importantly, he no longer rub his eyes and hence can start concentrate on his study.

pre op:  This girl has watery irritable eyes.  The worrying sign is there is a vessel growing into her cornea which if left progressive it may affect vision as it can cause scarring

 

Post op:  All lashes were brought out of the cornea with minimal evidence of surgery/scar.

pre op:  This boy has epiblepharon in upper and lower eyelid.  Note he even has to lift up his brow to see clearly.

Post op:  Note a much wide eye look and the forehead no longer need to lift to see better.

Pre op:  epiblepharon/lash ptosis in upper eyelid create a sleepy look and high astigmatism (5.75 D) in this case in 11 years old boy.

Post op:  You won't believe this is the same boy.  He looks much alert and can see better.  Unfortunately, because he operate at a relatively old age (> 6 years old) his astigmatism only reduce mildly.

 

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