Cryptophthalmos
-A rare failure of lid differentiation
-Skin over eye (no lids or palpebral fissure) that often blends in with the cornea which is usually malformed.
Congenital Coloboma
-Often well tolerated Involves primarily the upper lid
-no keratopathy
Ankyloblepharon
-Fusion of part or all lid margin: variant: Ankyloblepharon filiforme adnatum in which the lid margins are connected by fine strands.
Congenital Entropion
-Usually involves the lower lid
-Distal part of tarsus rotated inward
-Lashes abrade the cornea causing keratopathy
-Permanent corneal damage is uncommon
Epiblepharon
-A horizontal fold of skin adjacent to either the upper or lower lid
-Tolerated well by the cornea
-More commonly the lower lid
-Often spontaneously resolves in the initially years of life
-Surgery only indicated for severe cases
Congenital Tarsal Kink
-Child is born with the upper lid 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
Distichiasis
-An accessory row of lashes growing from the meibomian orifices or posteriorly
-The lashes are thinner, shorter, less pigmented and commonly well tolerated
Euryblepharon
-Enlargement of the lateral part of the palpebral aperture with downward displacement of the temporal 1/2 of the lower lid.
Epicanthus
-Crescentic fold of skin running vertically between the lids and overlying the inner canthus. There are three types:
–Inversus: If the fold is most prominent in the lower eyelid
–Tarsalis: (Most people) The fold is most prominent in the upper eyelid
–Palpebralis: If the fold is equally distributed in the upper and lower eyelids.
Telecanthus
-Normal interpupillary distance but wide intercanthal distance i.e. Waardenburg’s syndrome.