Euryblepharon

Abstract: Congenital eyelid malpositions can be isolated or associated with other structures such as the eyeball, ocular muscles, and lacrimal pathways. It is important to separate eyelid malpositions, which are topographical disorders, from eyelid malformations, which are constitutional morphological disorders. Only eyelid malpositions will be described in this paper, with a distinction made between static and dynamic disorders. Static disorders include epiblepharon, congenital ectropion and entropion, epicanthus, telecanthus, and centurion syndrome. Dynamic disorders group ptosis and congenital eyelid retractions. Epiblepharon is characterized by the absence of adhesion between the lower eyelid retractors and the orbicularis-skin layer, which allows the anterior lamella to roll over. Congenital entropion and ectropion are very rare. They most often require surgical treatment. Epicanthus involves a semi-lunar fold of skin extending from the upper eyelid across the medial canthal area to the margin of the lower eyelid. Four types (supra-ciliaris, palpebralis, tarsalis and inversus) of epicanthus are described. Treatment requires surgery. Telecanthus is defined as an increased distance between canthi. Primary telecanthus results from attenuation of the medial canthal tendons and is usually associated with other soft tIssue abnormalities such as epicanthus or blepharophimosis, or is seen after trauma. Secondary telecanthus is caused by underlying bony malpositions with an abnormal separation between the orbits because of an increased thickness of the interorbital bones such as that seen in hypertelorism or in other complex craniofacial syndromes. Euryblepharon is distinguished by an enlargement of the horizontal palpebral fissure associated with enlarged eyelids. The etiology is unknown and patients may benefit from surgery. Congenital ptosis is characterized by a deficiency of the levator muscle. They are most often unilateral and isolated. When associated with other abnormalities such as squint, synkinesis, blepharophimosis, or craniofacial syndromes, surgical treatment may require several-stage procedures. On the other hand, isolated congenital ptosis is usually treated in childhood (3-6 years) in a single stage. Congenital eyelid retractions may affect either the lower or the upper eyelid. They make up a rare condition and most cases are associated with craniofacial syndromes such as Crouzon or Apert syndromes. Upper eyelid retractions may spontaneously improve in some cases, but lower eyelid retractions do not. Treatment requires surgery, depending on the corneal consequences.

Abstract: Euryblepharon is a rare congenital anomaly of the palpebral fissure which consists of an increase in its width. A case has been described in which this characteristic is very marked, and associated with ectropion, lagophthalmos, corneal ulcers; also congenital malformations as twisted feet, hypospadia and inguinal hernia. Apart from a limited increase of the palpebral fissure in the mother, the familiar anamnesis is negative, and likewise examination of the cariogram and research of eventual metabolic modifications. An estimation of the various surgical techniques proposed revealed insufficient strictness regarding the standards generally followed in palpebral plastic surgery. Consequently, a technical variation was set up that will satisfy the needs of correct anatomical-surgical practice.

Abstract: A variety of eyelid anomalies can be present at the time of birth, seen as an isolated finding or in association with systemic syndromes. These anomalies can be broadly grouped as abnormalities of eyelid division, eyelid tissue defects (colobomas), congenital eyelid malpositions, and congenital eyelid lesions. Knowledge of basic embryology of the eyelid affords a better understanding of abnormalities, especially failures of eyelid development or palpebral fissure division such as cryptophthalmos and ankyloblepharon. Colobomatous eyelids must be considered from the standpoint of their potential for syndromic association, as well as for the challenges that can be involved in repairing these tissue defects. Congenital eyelid malpositions are often functionally and cosmetically significant, requiring effective management early in life. Finally, certain eyelid lesions may be apparent at birth or manifest in the weeks or months thereafter. Lesions with amblyogenic potential must be addressed in a timelier fashion.