6.3 Congenital eyelid malpositions

A very complex set of tiny muscles, tendons and other tissues is designed in such a way to permit the eyelids to smoothly, run across our eyes’ surface, thousands of times every day. The eyelids thus function as a wiper, the edges or margins of which must be perfectly smooth and angled in order to prevent ocular surface damage.

This complexity of the tissues around our eyes is occasionally slightly through out of balance resulting in children being born with a slightly in-turning (entropion) or less often out-turning eyelid (ectropion). More often yet, the eyelid margin is perfectly shaped but a fold of skin pushes the eyelashes onto the eye (epiblepharon). Sometimes despite normal tissue anatomy, an extra row of eyelashes can cause problems to the eye.

Though several of the above cases will see a slow spontaneous improvement with the development of a child’s face, qualified assessment only can filter out those more severe cases requiring surgical intervention to prevent eye damage.