Epiblepharon, commonly called inverted eyelashes, is a condition often seen among children of Asian descent. About 10 percent of Asian children are borne with the congenital defect — with nearly 46 percent diagnosed at birth, according to Sing Health, Singapore’s largest healthcare provider. Another 24 percent of the children are diagnosed by the age of one, and close to two percent from ages five through 18.
People with Down syndrome and obesity also may suffer from pronounced inverted eyelashes directly related to the extra folds of skin around their eyes. People with untreated thyroid disease also can develop a form of inverted eyelashes called secondary epiblepharon. An average of 72 percent of children, adolescents and adults diagnosed with epiblepharon have the condition on their lower eyelids. And the condition is more likely to strike both eyes.
Epiblepharon occurs when the eyelashes are turned inward, although the shape and position of the child’s eyelids are closer to normal. It’s similar to trichiasis, which is a much more common lid abnormality. Trichiasis is defined by the misdirection of the eyelashes toward the eyeball globe itself. Very often, it’s the result of an infection in the eyes.
Children with inverted lashes also have abnormal folds of skin close to the lower or upper parts of their eyelids. The extra horizontal folds of skin push the inverted lashes to rub against the cornea, which can lead to discomfort and irritation. Untreated, the constant rubbing can scratch the tender cornea and cause serous vision problems.
Symptoms Not Always Recognized
Because of the shape of the eyes on Asian people, there isn’t a large open section of visible eyelid. It’s often the redness or swelling on the top eyelids that lead parents to notice when a child is in discomfort or has some sort of abnormal development on the lids.
You should check with your ophthalmologist if your child exhibits symptoms commonly associated with epiblepharon. These can typically include:
- Eye redness
- Consistent watering that isn’t related to environmental factors
- Persistent complaints of itchy and painful eyes
- Frequent and constant eye rubbing
- Sudden light sensitivity or photophobia
If you see your child exhibit any of these habits, take him or her to an eye doctor as soon as possible. The earlier the condition is corrected, the better chance your child has of growing up with normal vision and little or no interruption of visual development. Since infants can’t tell you what’s bothering them, it’s vital that parents of Asian babies watch for these signs of inverted eyelashes that is so very common.
Causes Are Unsure
What causes the abnormality isn’t known, but the relatively common eyelid abnormality does happen in the womb. It’s thought to be the result of improperly developed muscles and tendons. Sometimes, it occurs simultaneously with more severe anomalies such as trichiasis and entropion — when the eyelid margin of rotation is total and the eyelashes actually face and touch the eyeball.
It is known, however, that the primary causes of epiblepharon in the lower eyelid are due to improper development of the lower lid retractor muscles. Doctors know this because of the absence of adhesion to the skin that is evident in normal eye development. Additionally, the tissue that connects the lid to the outer rim of the eye sits too close to the margin, leading to incorrect positioning of the eyelashes.
Steps You Can Take
Very often, children outgrow the inverted eyelashes as their facial bones grow. If the symptoms aren’t serious enough and as long as the risk to cornea damage remains low, you may not have to do anything except train your child to refrain from rubbing his or her eyes too much. The most important step, however, comes as soon as your child is diagnosed with epiblepharon: set up a regular schedule of ophthalmologist visits to monitor your child’s development and the progression of the condition.
When the situation doesn’t correct itself, then other treatments are available that usually include surgical interventions. Surgery usually is recommended when it seems like significant cornea damage has taken place or the child is complaining of increased pain and problems with vision.
Mild cases of epiblepharon often respond well to drops and preservative-free, hypo-allergenic topical lotions to soothe rough eyelashes, keep them from poking your child in the eye and eventually turn them back outward. Lubricating eye drops also are useful to use with younger children as they go through the growth spurts that eventually can lead to a complete turn-around of their inverted lashes.
Surgery is performed on older children who have not outgrown the condition and youngsters who suffer dramatically. The procedure involves cutting out a small section of skin and muscle on the rim of the affected eyelid to make room for the lid to roll out and allow the eyelashes to rotate out with the skin. A small incision and single suture is required. It may leave a faint scar, but it typically disappears over time.
The prognosis is good for youngsters who undergo treatment for inverted eyelashes. They go on to develop normal vision and rarely have complications or reoccurrences of the inversion. With such a positive prognosis, parents should feel free to discuss surgery with their doctors and ask for references to an ophthalmologist experienced in treating Asian children’s eyes.
Consequences of Avoidance
As with many other eye conditions, the devastating consequences that result from doing nothing far outweigh any slight risks associated with surgery. The most common side effects of surgery include:
- Reaction to the anesthesia
- Improper healing from not following post-operative directions closely
And most of those can be avoided when you visit an experienced eye surgeon you trust. Avoiding surgery or any other treatment, however, can have grave consequences for your child. Other complications that can occur if the inverted eyelashes go untreated can include:
- Persistent pain in the eyes, which often borders on severe
- Irreversible total blindness
- Repeated infections
- Recurring bouts of styes or conjunctivitis
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult eye doctor about your specific condition. Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper treatment.
Do you have any questions about Inverted Eyelashes (Epiblepharon) treatment and repair in NYC? Would like to schedule an appointment with Ophthalmologist or Optometrist Dr. Saba Khodadadian of Manhattan Eye Specialists, please contact our office for consultation with NYC eye doctor.
Dr. Saba Khodadadian, Optometrist (NYC Eye Doctor)
New York, NY 10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4821