Eyelid Disorders


Cryptophthalmos, is a very rare congenital malformation of the eye. It is characterized by skin passing continuously from the forehead to the cheek over a malformed eye (no lids or palpebral fissure). It may be isolated or more commonly as a part of Fraser syndrome. Cryptophthalmos has three classifications: complete, incomplete and abortive.

Congenital Coloboma

Congenital coloboma is a hole/defect of the iris of the eye. Most colobomas are present since birth. Any defect in the iris that allows light to enter the eye, other than through the pupil, is called a coloboma.


Ankyloblepharon is the fusion of the eyelids by webs of skin. It may be partial or complete, and the adhesions of the edges of upper with lower eyelid may be present since birth (congenital) or may be acquired. Sometimes the lid margins are connected by fine strands.

Congenital Entropion

Congenital entropion is a condition when the lower lid margin is rotated inward since birth. This results from malformed lower lid retractors, posterior lamella vertical insufficiency or kinking of the tarsal plate. The distal part of tarsus rotated inward, and the lashes abrade the cornea causing keratopathy. Permanent corneal damage is uncommon in this rare condition.


Epiblepharon is a condition in which the eyelid pretarsal muscle and skin ride above the eyelid margin to form a horizontal fold of tissue that causes the cilia to assume a vertical position. It is most common in the lower lids. This condition often spontaneously resolves in the initially years of life. Surgery is only indicated for severe cases.

Congenital Tarsal Kink

A congenital tarsal kink is a condition at birth when the upper lid is bent backwards often with a 180-degree fold in the upper tarsal plate. Corneal exposure and rubbing by the bent edge can lead to in ulceration. This condition often requires surgery.


Distichiasis is a disorder defined as the abnormal growth of lashes from the orifices of the meibomian glands on the posterior lamella of the tarsal plate (see following image). This condition is rare and can result in an accessory row of lashes. The lashes are thinner, shorter, less pigmented and often well tolerated.


Euryblepharon is a congenital eyelid anomaly characterized by enlargement of the lateral part of the palpebral aperture with downward displacement of the temporal 1/2 of the lower lid. The eyelid is shortened vertically compared with the horizontal dimension, with associated lateral canthal malpositioning and lateral ectropion abnormally wide lid opening.


Epicanthus is a condition when a fold of skin stretches from the upper to the lower eyelid, partially covering the inner canthus. There are three types: 1) inversus, when the fold is most prominent in the lower eyelid; 2) tarsalis, when the fold is most prominent in the upper eyelid (most people); 3) palpebralis, the fold is equally distributed in the upper and lower eyelids.


Telecanthus is a condition when there is an abnormally increased distance between the medial canthi and differs from orbital hypertelorism, which refers instead to an increased interpupillary distance or bony interorbital distance (dacryon to dacryon).


Blepharophimosis is a congenital anomaly in which the eyelids are underdeveloped such that they cannot open as far as usual and permanently cover part of the eyes. It is identified by vertically and horizontally shortened palpebral fissures and poor levator function.


Lipodermoids are abnormal epibulbar growths of the adipose tissue. A conjunctival lesion, the lipodermoid (dermolipoma) is usually located near the temporal fornix and is composed of adipose tissue and dense connective tissue. The overlying conjunctival epithelium is normal, and hair follicles are absent. Differentiation of benign lipodermoids from non-benign lesions is essential.


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