There is something special about the face of a smiling child. You can see happiness shine in their gleaming eyes. But sometimes children are born with eyelid malpositions that minimize that shine and interfere with visual function. When this occurs, even our littlest family members may require medical evaluation and care. The good news is that often a simple procedure can reposition eyelids and allow for the full expression of that child’s joy.

Two conditions that we commonly see in our office are congenital ptosis and epiblepharon.

before-after-eyes-1Congenital ptosis (“toe-sis”) occurs when a child is born with a drooping upper eyelid. It may affect one or both sides. It is important to recognize Ptosis early. Intervention is warranted when the condition prevents proper visual development. Children’s visual systems are very pliable in the early years of life. Any interference with vision may cause lack of proper visual development, and if this persists for long enough, the deficits may be permanent. If the child’s upper eyelid droops enough to cover the visual axis, their brain will not receive proper visual stimuli. In these cases, the eyelid must be surgically elevated to restore proper positioning.

before-after-eyes-2Epiblepharon occurs when there is an extra layer of muscle just beneath the lashes in the lower eyelid. This extra tissue pushes up against the lashes, causing them to rub against the eye. One or both sides may be affected. Children will often present with watering of the affected eye. They may also frequently rub the eye, or have redness. Crusting of the lashes often occurs in the morning after awakening. Children will often not complain of irritation of the eye, so careful observation is key. If the condition does not resolve on its own, surgical correction may be undertaken.

The key with both conditions is early observation and treatment to offer the child the best opportunity for maximum vision and full facial expression.

Dr. Hui is the founder of The Eyelid Institute in Palm Desert. She is an Oculoplastic surgeon and has a special interest in helping patients with Eyelid, Lacrimal and Orbital conditions. An Oculoplastic surgeon is a physician with combined training in Ophthalmic Plastic and Reconstructive Surgery (Oculoplastics) and Ophthalmology who has unique abilities to perform a variety of delicate procedures around the eyes. Dr. Hui can be reached at (760) 610.2677.

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