Conservative Management of Lower Eyelid Epiblepharon in Children

J Pediatr Ophthalmol Strabismus. 2017 Jan 1;54(1):15-16. doi: 10.3928/01913913-20160810-02. Epub 2016 Aug 18.


Purpose: Although much literature has focused on various techniques to repair epiblepharon, no study has addressed how frequently surgical intervention is required.

Methods: The authors tabulated data from all patients with epiblepharon seen over the past 15 years.

Results: Eighty-nine patients were included, 61 (69%) with tearing, discharge, conjunctival injection, or eye rubbing. Trichiasis was present in 15 cases (17%), 6 (7%) with corneal staining. In all cases, the initial treatment was conservative: antibiotic ointment or tear substitutes in 73 cases with trichiasis, symptoms of irritation, or corneal changes and observation in the remaining 16 cases. Three children (3%) were referred for eyelid surgery because of persistent symptoms. No patient had corneal scarring or long-term complications.

Conclusions: Although vision-threatening complications can result, a trial of topical antibiotic ointment and/or ocular lubricants was effective in nearly all patients. Most resolved with minimal symptoms. The few eventually requiring eyelid surgery suffered no long-term complications. The authors recommend a trial of conservative treatment before eyelid surgery is undertaken. [J Pediatr Ophthalmol Strabismus. 2017;54(1):15-16.].

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Conservative Treatment / methods*
  • Eyelid Diseases / congenital*
  • Eyelid Diseases / therapy
  • Eyelids / abnormalities*
  • Female
  • Humans
  • Infant
  • Male
  • Ointments
  • Ophthalmic Solutions / administration & dosage*
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Ointments
  • Ophthalmic Solutions

Supplementary concepts

  • Epiblepharon of Upper Lid