Epiblepharon with inverted eyelashes in Japanese children. I. Incidence and symptoms.

Abstract

SUMMARY Epiblepharon commonly occurs in Japanese infants and tends to disappear spontaneously with age. We examined 4449 Japanese children aged 3 months to 18 years for epiblepharon associated with inverted eyelashes touching the cornea. The condition was evident in 441 cases. We found that the incidence of epiblepharon decreased with age, but about 2% of high school students still had the condition. No sexual predilection was found. Lower eyelids were commonly involved bilaterally. Most cases of epiblepharon produced no or mild symptoms.Epiblepharon is characterised by a fold of skin that stretches horizontally across the upper or lower eyelid, usually associated with inversion of eyelashes.' It is reported to be common in infants of Oriental races.' To our knowledge no report details the incidence of this condition in recent Japanese literature. We therefore examined the incidence and symptoms of epiblepharon in Japanese children. Subjects and methodsA total of 4449 Japanese children in Shimane Prefecture were examined. Infants were seen on routine 3-month or 6-month screening tests at health centres. Children aged 1 to 6, 7 to 12, and 13 to 18 years were examined on routine ophthalmic screening at nurseries, elementary schools, and high schools, respectively.Epiblepharon was diagnosed as an extra fold of eyelid skin associated with inverted eyelashes touching the corneal surface. The condition was observed with a binocular loup. Corneal touch was confirmed by topical staining with fluorescein and was inspected in forward, upward, downward, nasal, and temporal eye positions. Epicanthus-like conditions were included in the diagnosis when inverted eyelashes produced corneal touch, because the condition was too difficult to differentiate from epiblepharon. Children who had undergone surgery for epiblepharon were also included, even though the condition had been resolved.

Ocular Findings in Japanese Children with Nephrotic Syndrome Receiving Prolonged Corticosteroid Therapy

“…The high body mass index (overweight and obesity) was associated with epiblepharon in pediatric patients with nephrotic syndrome. The prevalence of epiblepharon in children with nephrotic syndrome was higher than that in Japanese school children, as reported previously by us [11, 16]. Carter et al [17] reported that orbital fat projected further anteriorly with respect to the orbital rim in the lower eyelid in all Asians.…”

Characteristic ocular findings in Asian children with Down syndrome

“…Second, the incidence of epiblepharon in non-DS Asian children, decreases with age, and only 4.2% showed epiblepharon after 7 years of age. 18 In contrast, the incidence of epiblepharon did not decrease with age much among the patients with DS, and 53% of the patients after 7 years of age still showed epiblepharon. Third, photophobia or epiphora, a common symptom of epiblepharon, was noticed much less commonly in DS children with multiple corneal punctate epithelial erosions than non-DS Asian children in the same situation.…”

“…First, in non-DS Asian children with epiblepharon, the medial part of the lower eyelid was most commonly involved, and the upper eyelid, the least commonly involved. 18 However, in the epiblepharon with DS, the upper eyelid was characteristically most commonly involved. Second, the incidence of epiblepharon in non-DS Asian children, decreases with age, and only 4.2% showed epiblepharon after 7 years of age.…”

An Infant Case of Graves' Disease with Ophthalmopathy

“…Also, entropion was not described in children in other studies, except that of Wada et al Entropion is not due to thyrotoxicosis but to secondary anatomical abnormalities. Epiblepharon commonly occurs in Japanese infants; 4449 Japanese children were examined for epiblepharon associated with inverted eyelashes and 441 cases of this condition were observed [15]. Therefore, Japanese infants with Graves' disease, including our case, might show a tendency to have entropion due to epiblepharon as well as lower lid retraction.…”