Our patient had facial malformations (depressed nasal bridge, anteverted nostrils, thin upper lip, downturned mouth corners, bilateral epicanthus
, and micrognathia), and hypoplasic distal phalanxes and nails in the left hand as additional anomalies.
Frontal inspection revealed epicanthus
, low-set ears and typical fascial expression "mask-like appearance" caused probably by bilateral facial nerve involvement (Figure 1).
The normative values of size and slant of palpebral fissure may be valuable for the clinician in the assessment of ptosis, malar hypoplasia, and epicanthus
10%, hypertelorism 3%, ptosis 1%, nystagmus 0.
In addition to hypertelorism has folds of skin that covers the inner corner of eye or epicanthus
Quite often, the optometrist is presented with cases of suspected pseudo-esotropia: where a large epicanthus
leads the parent to suspect a strabismus but where none can be found on cover testing.
Bethan was born with a syndrome called Blepharoptosis Epicanthus
, in other words she has droopy eyelids.