Eyelid Imbrication Research Articles

Congenital eyelid imbrication syndrome: a rare occurrence in Pakistan

Congenital eyelid imbrication syndrome (CEIS) is a rare condition presenting at birth and is characterised by overriding of the upper lid on the lower lid. It is due to longer upper lid, than the lower lid. Overriding leads to spontaneous eversion of the upper lids. In our patient, examination revealed canthal tendon laxity and hyperaemia of the tarsal conjunctiva. All the rest of the structures in the eyeball and adnexa were normal. Spontaneous eversion occurred in two weeks as the upper lid grew with time. No treatment was required. Keywords: Congenital imbrication syndrome, Overriding upper lid, Hyperaemic conjunctiva, Floppy eyelids.

Floppy eyelid syndrome combined with eyelid imbrication in a child with trisomy 21

Floppy eyelid syndrome combined with eyelid imbrication in a child with trisomy 21

Novel surgical approach to refractory eyelid imbrication

Novel surgical approach to refractory eyelid imbrication

Congenital eyelid imbrication syndrome in a neonate: A rare case

A full-term newborn was examined after lower segmental cesarean section. There were no antenatal complications. Clinically, there was overlapping of upper lids over lower eyelids when the baby was crying, but reduced when the baby was asleep. The upper eyelids became normal within 2 days of delivery without any treatment. We report one such case.

Congenital bilateral eyelid imbrication in a neonate: A rare case

A newborn male child with polycythemia had watering and discharge from both eyes. In antenatal period, the mother had severe oligohydramnios. Clinically, both upper eyelids completely overlapped the lower and on forceful mechanical opening, spontaneous eversion was observed. The review of pathogenesis and management of eyelid imbrication syndrome is provided in this report.

Lateral Canthal Tendon Disinsertion: Clinical Characteristics and Anatomical Correlates.

To highlight features of lateral canthal tendon disinsertion (LCTD), provide an algorithm for systematic assessment, and describe the anatomic genesis of signs and symptoms. Retrospective case series of consecutive patients with lateral canthal tendon disinsertion, who underwent lateral canthal tendon fixation by a single surgeon (DTT) between 2004 and 2011. One hundred and seventeen eyes in 90 patients underwent lateral canthal tendon fixation. Average age was 69.3 ± 17.9 years. Twenty-three percentage of eyes had undergone lower eyelid blepharoplasty and 52% had undergone lateral canthal tightening; 35% had no previous periocular surgery. Patients with purely involutional lateral canthal tendon disinsertion were significantly older (76.1 ± 7.8 years of age; p < 0.03). Six key features associated with lateral canthal tendon disinsertion were identified. On static evaluation: 1) a blunted or vertically displaced lateral canthal angle; 2) a narrow horizontal fissure with reduced temporal scleral triangle; and 3) pseudo eyelid retraction. On dynamic evaluation with attempted closure: 4) medial and inferior movement of the lateral commissure; 5) incomplete apposition of the eyelid margins in the absence of anterior lamellar shortage; and 6) temporal eyelid imbrication. Improved blink dynamics with manual lateral canthal tendon complex repositioning ("the thumb test") predicted a favorable outcome with surgical tightening in 95.7% of cases. Lateral canthal tendon disinsertion results in altered eyelid fissure symmetry, blink dynamics, and lacrimal pump function. The authors recommend the mnemonic-A.B.C.: for Aperture configuration, Blink dynamics, and eyelid Closure-to structure the examination of all symptomatic patients. Manual restoration of the disinserted lateral canthal tendon with the "thumb test" predicts favorable outcomes with surgical fixation.

Congenital combined eyelid imbrication and floppy eyelid syndrome: Case report and review of literature

Congenital eyelid imbrication syndrome (CEIS) is an extremely rare, benign, transient, self-limiting eyelid malposition disorder. The classic triad of signs in patients with a CEIS consists of bilateral upper eyelids overriding the lower eyelids when child was in sleep, bilateral medial and lateral canthal tendon laxity and tarsal conjunctival hyperemia. We report a third case of congenital combined eyelid imbrication and floppy eyelid syndrome in healthy neonate that was resolved within a week with conservative treatment.

Congenital combined eyelid imbrication and floppy eyelid syndrome

Eyelid imbrication syndrome is an idiopathic acquired eyelid disorder characterized by upper eyelids overriding the lower eyelids. Congenital eyelid imbrications syndrome is extremely rare and thorough review of literature revealed only two previously reported cases and one congenital combined eyelid imbrications and floppy eyelid syndrome. We report a third case of bilateral asymmetric congenital eyelid imbrication syndrome and a second case of congenital combined eyelid imbrication and floppy eyelid syndrome that resolved with conservative treatment.

Congenital eyelid imbrication syndrome

Congenital eyelid imbrication syndrome

Congenital eyelid imbrication syndrome

Purpose To describe congenital eyelid imbrication syndrome and its possible pathophysiology. Design Clinical observational case report. Methods A full-term newborn was examined after a vaginal delivery and uneventful pregnancy. Results The upper eyelids were overlapping the lower eyelids when the eyes were closed or when the newborn was asleep. The upper eyelids resumed normal position gradually over a week without causing any symptoms or residual sequelae. Conclusions Eyelid imbrication syndrome is a rare cause of congenital eyelid malposition. It may be caused by inborn laxity of the upper medial and lateral canthal tendons that are tightened during the postnatal period, causing resolution of this condition.

Diseases of the eyelid-conjunctival complex and corneal complications of lid disease.

The vascular anatomy of the eyelids has been studied in more detail with regard to possible applications in eyelid surgery. The recognition of different subtypes of eyelid laxity, eg, floppy eyelid, lax eyelid, and eyelid imbrication syndromes, as underlying causes of conjunctival and corneal irritation will contribute to their successful management. Involvement of eyelid, conjunctiva, or cornea has been reported in association with systemic diseases such as Wegener's granulomatosis, xeroderma pigmentosum, scleromyxedema, sarcoidosis, and abnormalities of mitochondrial DNA. The ocular manifestations may be the presenting feature of the underlying disease. Results in two series of patients with ocular surface diseases such as chemical and thermal eye burns suggest that the use of autologous nasal mucosa transplantation is promising for the management of this disorder. Clinical features and results of cryotherapy are reviewed in two series of patients with congenital distichiasis and trichiasis due to ocular cicatricial pemphigoid.

Eyelid Imbrication: An Unrecognized Cause of Chronic Ocular Irritation

Eighteen patients with chronic ocular irritation were examined over a 3-year period. All patients demonstrated papillary conjunctivitis and, occasionally, tarsal ulcers. Six also had floppy eyelid syndrome. Underlying every patient's symptoms was the overriding or imbrication of a lax upper eyelid on an often equally lax lower eyelid, allowing lower eyelid lashes to chronically rub the upper eyelid tarsal conjunctiva. Chronic ocular irritation in five patients was managed with ocular lubricants. Two of these patients had floppy eyelid syndrome and required nightime shielding for nocturnal eyelid eversion. Thirteen patients underwent eyelid surgery to correct the overriding upper eyelid. Surgical procedures included full-thickness upper eyelid wedge resection, lateral canthal tendon plication, and lower eyelid horizontal shortening, using a tarsal strip procedure. Follow-up averaged 2.5 years. Symptomatology was adequately controlled in all patients. In addition to the five patients who received medical treatment for their symptoms, two with complicated ocular problems required continued ocular lubrication after surgery. Seven patients were successfully treated with eyelid shortening procedures and lateral canthal tendon plication. The remaining six patients underwent a variety of additional eyelid surgeries. All patients undergoing surgery had complete resolution of eyelid imbrication. Eyelid imbrication is a previously unrecognized cause of chronic ocular irritation. In this condition, eyelid laxity causes the upper eyelid to override the lower eyelid, allowing the lower eyelid to chronically rub and chafe the upper eyelid tarsal conjunctiva. In some cases, symptoms can be managed medically. More often, surgical intervention is required to correct eyelid laxity and prevent overriding of the upper eyelid.