Twenty two patients with primary congenital lid retraction affecting either the upper or lower eyelids or both are presented. The clinical features and management are discussed in the hope that recognition of this clinical entity will prevent unnecessary investigation. Eyelid retraction is usually secondary to thyroid disorders, trauma, proptosis, seventh nerve palsy, or neurological abnormalities affecting the third nerve. Primary congenital lid retraction has been described only relatively rarely as individual case reports.'-It is not well recognised as a clinical entity, and so individual patients may be investigated unnecessarily and the diagnosis not considered.7 This report reviews the findings in 22 patients with congenital lid retraction affecting either the upper or lower eyelid.
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