Congenital Anomalies Lid Disorders
A rare failure of lid differentiation. Skin over eye (no lids or palpebral fissure) that may be merged in with the cornea, which is usually malformed.
Involves primarily the upper lid. No keratopathy.
Fusion of part or all lid margin: variant: Ankyloblepharon filiforme adnatum in which the lid margins are connected by fine strands.
Usually involves the lower lid. Distal part of tarsus rotated inward. Lashes abrade the cornea causing keratopathy. Permanent corneal damage is uncommon.
A horizontal fold of skin adjacent to either the upper or lower lid (most commonly on lower lid). Tolerated well by the cornea. Often spontaneously resolves later in life. Surgery only needed in 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 result in ulceration.
An accessory row of lashes growing from the meibomian orifices or posteriorly. These lashes are thinner, shorter, less pigmented and commonly well tolerated.
Enlargement of the lateral part of the palpebral aperture with downward displacement of the temporal 1/2 of the lower lid.
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.
Normal interpupillary distance but wide intercanthal distance. i.e. Waardenburg’s syndrome.
Vertically and horizontally shortened Syndrome palpebral fissures.
Drooping of the upper eyelid.
Solid tumors that are most often found underneath the conjuctiva adjacent to the superior temporal quadrant of the globe