Epiblepharon Gallery Patient 283693

More Than Just Squinting

When Elijah first came to see Dr. Lichtenstein, he had been squinting, tearing, and avoiding bright light for years. His family knew something wasn't right, but the underlying problem had never been properly identified. Along the way, he had been given several different diagnoses and had undergone multiple attempts at treatment.

The actual diagnosis was epiblepharon, a condition in which excess lower eyelid skin pushes the eyelashes upward and inward against the surface of the eye. With every blink, the lashes rubbed against the cornea, causing chronic irritation, light sensitivity, tearing, and the constant squint visible in Elijah's photograph on the left.

A Twenty-Minute Fix

Although Elijah had struggled with the problem for years, the solution did not take long.

A procedure lasting approximately twenty minutes was performed to remove the excess skin and redirect the eyelashes away from the cornea. A few absorbable sutures were placed, and no future procedures are anticipated.

One important thing to understand is that most children with epiblepharon do not need early surgery. Many have only mild symptoms, and the condition often improves spontaneously as the face matures. As the lower eyelid develops, it gradually rotates outward and the lashes move away from the cornea.

For this reason, surgery can often be delayed until a child is four or five years old, and many children never require surgery at all. Early intervention is generally reserved for children with significant symptoms, substantial corneal irritation, or both. Knowing the difference is where experience matters.

The Result

By the evening after surgery, Elijah was already opening his eyes more comfortably.

The photograph on the right was not taken immediately after surgery. It was taken approximately eighteen months later, when Elijah returned for a routine eye examination.

By then, the tearing, squinting, and light sensitivity were long gone. His eyes felt normal, his lashes no longer touched his corneas, and he was finally able to go about his day without the constant irritation that had affected him for so long.

The Lesson

Children who are persistently squinting, tearing, rubbing their eyes, or avoiding bright light should be evaluated by an experienced eye surgeon. There are many potential causes, and sometimes the answer is hiding in plain sight: eyelashes rubbing against the eye with every blink.

For children with significant epiblepharon, recognizing the diagnosis is often the hardest part. Once identified, treatment can be simple, highly effective, and life-changing. In Elijah's case, years of discomfort were resolved with a short procedure and a few absorbable stitches.