Epicanthal Folds in Baby/New Born

January 12, 2017

Epicanthal folds are skin folds of upper eyelid. These skin folds covers the whole eye horizontally and lean downwards to inner corner of eye. It is normally present in Asians especially Korean, Japanese and Chinese population. It is a congenital trait which is transferred to infants from parents. It is normal in new born babies and infants which disappear after 3 to 6 months of gestation period. It is like swelling on whole face of baby. Eye with Epicanthal folds look like almond shape. It is harmless and disappear on its own. But Epicanthal folds do not disappear if there is a disease behind it. It may occur due to Down syndrome, fetal alcohol syndrome and many other congenital diseases. If these folds occur without any disease, then these folds will not cause any harm to vision. Sometimes there is difference in both eyes of infant due to Epicanthal folds and this condition is then known as strabismus.

Infants with Epicanthal folds lack crossed eyes but if crossed eyes are present then it is called pseudo strabismus. Epicanthal folds are considered a minor symptom of some congenital diseases like Down syndrome, fetal alcohol syndrome, strabismus and pseudo strabismus. If Epicanthal folds are mild then these will cover less than half or one third of caruncle. If Epicanthal folds fall in moderate category, then these will cove half of caruncle and in case of severe Epicanthal folds, these cover whole of the caruncle and cause complications. Epicanthal folds have 4 main types according to part of eye involved. Like in Epicanthal inversal the lower part of canthus is involved, in other types both upper and lower part and sometimes only one part is involved.  Other symptoms of Epicanthal folds include flat nasal bridge due to mal distribution of skin tissues. Face look flat and distance between both eyes increases than normal.

All these features make people UN attractive. If other symptoms persist, then these symptoms will be associated with leading disease behind Epicanthal folds. Epicanthal folds can be corrected with a specially designed surgery named epicanthoplasty. In this surgery, a minor cut is made on skin and then tissues from innermost layer of medial canthus are removed. Then the cut is stitched. The stitches will take a week to remove. This surgery will help in removing Epicanthal loose skin folds and alignment of eye is also attained. It is a safe but sensitive procedure, care is required during and after surgery because canthus is the sensitive part of eye. This surgery leaves mark on eye that’s why some people do not prefer it.

People normally do not have this surgery until these Epicanthal folds and flattened nasal bridge cause any complications regarding vision and breathing. There are also some other surgeries which are performed according to the type and severity of Epicanthal folds. If these Epicanthal folds appear as a symptom of diseases like down syndrome and alcohol fetal syndrome, then surgery is rarely performed because doctor prefer to treat the leading disease 1st.