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A minor abnormality of the eyelids, an epiblepharon might go unnoticed, or it might cause eye disease. An epiblepharon is an unnecessary and superfluous skin fold on the eyelid. This can fold the lid down in an abnormal manner and cause the eyelashes to turn in, thereby irritating the eye.
Most common in people who have Asian or Hispanic ancestry, the extra skin fold can affect the top or the bottom lid. It is caused by the presence of too many muscle fibers in the lid and too much skin. Typically, an epiblepharon is found at the edge of the eyelid and runs horizontally across the lid. The condition is present at birth and does not develop later in life.
The presence of this skin can affect the direction in which the eyelashes grow. Instead of growing outward and away from the eye, like most people's eyelashes do, the lashes can grow inward, facing the eyeball. This can cause a medical condition known as entropion, in which the eyelashes rub against the eyeball and the cornea becomes irritated.
This worsens over time, and the affected person exhibits symptoms such as eye soreness, abnormally high tear production and an aversion to looking at light. The abnormal placement of the eyelashes is most obviously noticeable when the person with epiblepharon looks downward. The presence of the condition might go undiagnosed, especially in children, by doctors who are treating regular eye irritations. If the extra skin is present on the top lid, the lid can appear saggy with too much skin, in a similar manner to another, unrelated eye condition called blepharochalasis.
Surgery is a possible option to treat an epiblepharon that causes medical problems such as corneal irritation. The procedure simply removes the excess skin and thereby allows the lashes to grow outward, away from the eyeball, in a normal fashion. This procedure might not even necessitate an overnight stay in a clinic or hospital. As epiblepharon tends to get less troublesome as the patient grows older, and the surgery might not even be necessary for some people.
Epiblepharon is similar to another eye condition that can present at birth called congenital entropion. Entropion refers to any eye condition caused by inward-facing lashes. Congenital entropion, on the other hand, refers specifically to an eyelid that develops without skin folds, so the eyelashes always face in, as opposed to epiblepharon, in which the superfluous skin fold is the source of the problem.