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PHOTO ESSAY
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 837-838

Unilateral congenital eyelid eversion syndrome


Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry, India

Date of Submission19-Feb-2022
Date of Acceptance31-Mar-2022
Date of Web Publication16-Jul-2022

Correspondence Address:
Dr. Sandip Sarkar
Department of Ophthalmology, Jawaharlal Institute Postgraduate Medical Education and Research, Puducherry - 605 006
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_494_22

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  Abstract 


Keywords: Congenital, eyelid eversion, unilateral


How to cite this article:
Sarkar S, Raja G, Agarwal D, Kasturi N, Jossy A. Unilateral congenital eyelid eversion syndrome. Indian J Ophthalmol Case Rep 2022;2:837-8

How to cite this URL:
Sarkar S, Raja G, Agarwal D, Kasturi N, Jossy A. Unilateral congenital eyelid eversion syndrome. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Oct 6];2:837-8. Available from: https://www.ijoreports.in/text.asp?2022/2/3/837/351196



A 2-hour-old male neonate, born out of a nonconsanguineous marriage, was referred to us from the neonatology department with complaints of right upper eyelid swelling and eversion since birth. The mother had an uneventful antenatal period, and delivery was spontaneous vaginal at term with no history of instrumentation or birth trauma. The child did not have any systemic abnormalities. On ophthalmic evaluation, eversion of the right upper eyelid with marked conjunctival hyperemia and chemosis was noted [Figure 1]a and [Figure 1]b. The anterior segment and fundus examination were unremarkable. Attempts of manual reposition of the eyelid were unsuccessful. The patient was treated with topical antibiotic eye drops, lubricants, steroid ointment, and hypertonic saline (5%) eye drops to osmotically reduce the chemosis. On the third day, the chemosis started to decrease, and the eyelid returned to normal anatomic position when the baby was quiet [Figure 1]c but everted while crying [Figure 1]d. At 2 weeks follow-up, the lid retained the normal position, the conjunctiva was healthy, and the cornea was clear [Figure 1]e and [Figure 1]f.
Figure 1: (a and b) Eversion of the right upper eyelid with marked conjunctival hyperemia and chemosis; (c) on the third day, eyelid returned to normal anatomic position when the baby was quiet and (d) everted while crying; (e and f) at 2 weeks follow-up, the lid retained the normal position, the conjunctiva was healthy, and transparent cornea

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  Discussion Top


Congenital upper eyelid eversion is a rare congenital condition characterized by eversion of upper eyelids and conjunctival chemosis. The incidence appears higher in black infants, infants with trisomy 21, and infants born with collodion skin disease.[1] The occurrence has been attributed to birth trauma, reduced tone of the orbicularis muscle, vertical shortening of the anterior lamella or vertical elongation of the posterior lamella of the eyelid, failure of the orbital septum to fuse with the levator aponeurosis, and defective lateral canthal ligament of the eyelid.[2] Previous reports and our own experience have shown that it can be successfully managed conservatively with topical hypertonic therapy, lubricants, and antibiotic-corticosteroid therapy. Surgical treatment options include temporary tarsorrhaphy, subconjunctival hyaluronic acid injection, fornix sutures, and full-thickness skin graft to the upper lid.[2],[3] Prompt management is necessary to restore the anatomical and functional eyelid position and prevent corneal complications.

Ethical approval

Written informed consent for publication (including the images) has been obtained from the parent of the patient. All procedures carried out were in accordance with the tenets of the Declaration of Helsinki. Institute Ethics Committee approval is not required for a case report according to Indian Council of Medical Research guidelines.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Maheshwari R, Maheshwari S. Congenital eversion of upper eyelids: Case report and management. Indian J Ophthalmol 2006;54:203-4.  Back to cited text no. 1
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2.
Daniel P, Cogen M. Conservative management of congenital upper eyelid eversion. J AAPOS 2020;24:46-8.  Back to cited text no. 2
    
3.
Almajed F, Alsulaiman HM, AlMadhi N, Schellini SA, Sesma G. Congenital bilateral upper lid eversion. Saudi J Ophthalmol 2020;34:324-7.  Back to cited text no. 3
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