Conservative Management in Congenital Bilateral Upper Eyelid Eversion

Abstract

Aim. To report the case of congenital bilateral upper eyelid eversion with severe chemosis that was successfully managed conservatively. Report. The patient was a six-hour-old male neonate with bilateral congenital upper eyelid eversion and severe chemosis, following uneventful delivery. Conservative management consisted of the application of antibiotic ointment and padding the exposed conjunctiva with 5% hypertonic saline-soaked gauze. The eyelids reverted spontaneously on day 3 and the condition was completely resolved by the third week. Conclusion. Congenital upper lid eversion is usually a benign condition which responds well to conservative treatment. Creating awareness amongst healthcare professionals is essential.

Unilateral congenital eyelid eversion: An unusual presentation

“…This is in line with the literature that has demonstrated the effectiveness of conservative management strategies in congenital eyelid eversion. [1][2][3][4] Surgical interventions such compression sutures, temporary tarsorrhaphy, subconjunctival injection of hyaluronic acid, fornix sutures and even full thickness skin grafts should only be considered if more rapid resolution is preferred [5] or conservative measures fail because of inherent lid abnormalities. The time it takes to completely resolve eyelid eversion using…”

“…conservative measures varies from a few days to weeks in the literature. [1][2][3][4] The rapid response in this case was probably due to a milder form of congenital eyelid eversion. The goal of management is to prevent desiccation of the exposed conjunctiva and cornea, allowing for spontaneous resolution of the eyelid eversion.…”

“…The goal of management is to prevent desiccation of the exposed conjunctiva and cornea, allowing for spontaneous resolution of the eyelid eversion. [4] This is achieved by breaking the vicious cycle of eyelid eversion, orbicularis muscle spasm, venous congestion and worsening conjunctival oedema. The rationale behind using 5% hypertonic saline dressings is that they create an osmotic gradient that results in the movement of fluid from the oedematous tissue through the semipermeable conjunctival membrane.…”

Congenital ectropion

“…At 4 weeks of follow-up, both upper eyelids returned to normal position without any sequelae (figure 1B). Congenital ectropion is a rare condition with unknown aetiopathogenesis that can have an asymmetric presentation and can be managed successfully with conservative treatment 1–3…”

“…These methods resolve congenital ectropion in few days to weeks. The severe, non-resolving cases may need surgical interventions like subconjunctival hyaluronidase injection, temporary tarsorrhaphy, excision of redundant conjunctiva and compression suture 2 4 5…”