What is a Palpebral Fissure?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 21 November 2019
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The palpebral fissure is the space in the corner of the eye between the eyelids, in the area where the lower and upper lids meet. There are some normal variations in size and shape of this anatomical feature that can occur between populations. Abnormalities of the palpebral fissure are associated with certain congenital conditions. For patients who experience problems because of abnormalities, surgery to correct the problem can be performed by a surgeon who specializes in oculoplastics, a branch of surgery focused on reconstruction and repair of the eye and surrounding area.

In most people, the palpebral fissure is horizontal and quite small, about a third as tall as it is wide. People may notice that it sometimes collects fluids extruded from the eye, and it may become crusty or irritated as a result. In people with active eye infections, this region may become red and inflamed. The length of the fissure varies slightly between different populations. Injuries to the eyelids can sometimes cause tears to the area that may distort or damage it.

Certain congenital abnormalities can cause this structure to slant, usually upwards, and may make it longer or wider than it is in most individuals. These variations are primarily cosmetic in nature and should not cause health problems for the patient. They can also be a telling diagnostic sign that can be used in a workup of an infant who appears to have a congenital abnormality.


Some conditions associated with changes to the palpebral fissure include trisomies, in which someone inherits three copies of a chromosome instead of two, as well as fetal alcohol syndrome and Grave's disease. Usually the patient has a number of other symptoms that are indicative of a medical problem, including other variations in facial structure such as a flattened nose.

Other problems that can involve this area of the eye include infections, inflammation, and irritation. It is also possible for sties, skin tags, and boils to form in the palpebral fissure. These can be painful and uncomfortable for the patient and may lead to irritation of the eye if they are allowed to grow. Treatment options can include medicated eye drops to reduce inflammation and treat infection. Keeping the eyes clean by washing the face regularly with warm to hot water and soap will help maintain eye health and prevent infection and irritation of the eyes. People with chronic eye conditions may want to discuss the issue with an ophthalmologist.


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Post 2

It is alarming that congenital disorders are set in place even before a mother and father conceive their child. Studies show that a mother's and father's diet and glucose levels even before ovulation can effect the baby that is about to be conceived! It is also alarming that something as simple as a slanted/abnormal palpebral fissure can indicate that a newborn baby may have something more serious that just a cosmetic abnormality.

The palpebral fissure, although small, seems like it can effect the look and the condition of your eyes significantly. I always get debris to build up in my palpebral fissure after a long night of sleep. I have also had a sty on my palpebral fissure, and that was both painful and annoying. It took about a month for my sty to go completing away and for my palpebral fissure tissue around it to lose all it's skin irritation.

Post 1

My niece was born with Down syndrome and has palperbral fissures that slant upwards. This is a typical look for a person with Down syndrome. Their eyes appear a little smaller and slanted upwards.

I don't know if this affects her vision or not. She is 13 years old and doesn't wear any glasses.

I have seen many Down syndrome children with glasses. I have always wondered if this is because of the palperbral fissures or if it just depends on each individual child.

She is such a joy to be around and is always smiling and happy.

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