What are Epicanthal Folds?

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  • Last Modified Date: 07 January 2020
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The epicanthic or epicanthal folds are either of no significance whatsoever or a potential disease marker, especially in newborns. The appearance of the fold typically means that a small amount of skin may cover the inside corners of the eye. When a person’s eyes are open, the fold on the upper lid can look as though the upper eyelids have disappeared and are not prominent. This is frequently referred to as the Asian eye, since many people of Asian descent, and a few of other cultures have this feature.

In an Asian child or adult, possessing epicanthal folds is not associated with any type of health problems. It is fair to state that it has sometimes led to discriminatory problems, to the degree that some Asians in interacting in Western culture sought to reduce the ethnicity of their appearance by plastic surgery called epicanthoplasty. This surgery was most common after World War II, particularly in Japan or among Japanese living in the United States. Greater acceptance of race and significant decline in racism toward the Japanese has gradually reduced the frequency of these surgeries.


As much as having epicanthal folds can reflect racial background, it may also signify the presence of certain problems in a newborn, including some serious genetic disorders. For instance, the epicanthal fold is present in most people who have Down syndrome, but it may also be found in those who have rarer genetic disorders like Turner’s syndrome, or Noonan’s syndrome, or in acquired conditions like fetal alcohol syndrome. Occasionally a premature baby has this too, since the epicanthal fold develops in all babies.

What may confuse matters is that just about any child could have the expression of epicanthal folds right at birth. As the child grows, the nose bridge increases in height and the appearance of fold simply disappears for those not genetically inclined toward this eye appearance. Thus even in children of any race, the fold isn’t necessarily suggestive of illness or medical condition.

On the other hand, given the potential severity of some of the illnesses epicanthal folds might suggest, it is always a good idea to mention its presence to a doctor. Doctors can evaluate it and look for other signs that would be suggestive of a serious disorder. Another litmus test of sorts is that certain people won’t outgrow the folds, though genetically it’s not something they would be likely to have. Instead, they’ll continue to have epicanthal folds in evidence all the way into adulthood.


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Post 5

I am not of Asian descent, but over the past five or so years, I have developed epicanthal folds in both eyes. I have been highly depressed and used to cry all the time. I don't know if its from some sort of infection from constant tears or what? It would even be from old age. I did cry six or eight years away. Believe it or not, it is the truth.

Post 4

@Kristee - Epicanthal folds in infants are pretty common. I work in a hospital, and I see a lot of newborns with these.

Of course, most of them will go away with time. The babies born with Down syndrome have really narrow, slanted eyes, so it's easier to tell if this is the issue that the folds point toward.

They also usually have a protruding tongue and tiny ears. Their faces are flat, and they have legs and arms that are short in proportion to their bodies.

Post 3

Is there a way to distinguish a regular epicanthal eye fold from one that a Down syndrome baby has? My sister will be giving birth in a few weeks, and I would like to know how to tell a harmless epicanthal fold from one that signifies a disorder.

Post 2

@wavy58 – I've seen some before and after epicanthal folds surgery pictures, and the results are usually pretty dramatic and impressive. Maybe your friend should see a different surgeon to have it fixed.

I know that some Asians see anyone who has this type of surgery as a traitor to their heritage. In their eyes, they are trying to deny their nationality or trying to look more American. Hopefully, your friend's family didn't disown her after the surgery.

Post 1

I have an Asian friend who had epicanthal fold surgery, and she regretted it. It did not turn out like she had hoped, though personally, I think she will just never be happy with her appearance.

She moved here five years ago to go to college, and she has been trying to fit into our culture ever since. The surgery was a big part of this, and it was very important to her.

I will admit that now, her eyes don't look as symmetrical as they did before. However, I think that the difference is minute and probably no one else will notice it.

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