Epicanthic Folds and Hooded Eyelids, similarities and differences

 Epicanthic folds are skin folds of the upper eyelid that cover the inner corner of the eye. There are four main types:

- Epicanthus Supraciliaris: This type runs from the brow, curving downwards towards the Lacrimal sac. - Epicanthus Palpebralis: Beginning above the upper tarsus, it extends to the inferior orbital rim. - Epicanthus Tarsalis: Originating at the upper eyelid crease, it merges into the skin near the medial canthus. This type is most often found in East Asians. - Epicanthus Inversus: This type runs from the lower eyelid skin over the medial canthus and extends to the upper lid . These folds are more common in certain populations, including East Asians, Southeast Asians, Central Asians, North Asians, Polynesians, Micronesians, Indigenous peoples of the Americas, and some African people ¹. They can also be associated with various medical conditions, such as Down syndrome, Zellweger syndrome, and Noonan syndrome
In terms of eye health, epicanthic folds may: - Decrease eye opening: Epicanthic folds can make the eye opening smaller, potentially affecting vision . - Increase risk of eye problems: While rare, epicanthic folds may be linked to conditions like blepharophimosis syndrome, which causes narrow eye openings and droopy eyelids . - Affect tear distribution: The folds can alter tear distribution, potentially leading to dry eye or other issues .

Keep in mind that epicanthic folds are common and typically do not require treatment unless associated with underlying conditions

SURGICAL indications for altering Epicanthic folds:

Plastic surgeons may consider reducing epicanthic folds in the following situations: Cosmetic Reasons 1. Aesthetic preference: Some individuals want to alter their eye shape for cosmetic reasons. 2. Improved eye symmetry: Reducing epicanthic folds can enhance eye symmetry. Functional Reasons 1. Visual obstruction: Large epicanthic folds may obstruct vision or cause eye strain. 2. Eyelid drooping (ptosis): Epicanthic folds can exacerbate ptosis. Medical Conditions 1. Blepharophimosis syndrome: Epicanthic folds can be part of this condition, requiring surgical correction. 2. Eyelid abnormalities: Certain conditions, like eyelid ectropion or entropion, may require epicanthic fold reduction. Surgical Procedures 1. Epicanthoplasty: A surgical procedure specifically designed to reduce epicanthic folds. 2. Blepharoplasty (eyelid surgery): Epicanthic fold reduction can be combined with blepharoplasty.

Hooded Eyelids Vs. Epicanthic folds

Hooded eyelids and epicanthic folds are related but distinct features: Hooded Eyelids 1. Characterized by excess skin on the upper eyelid. 2. Skin folds over the eyelid crease. 3. Can cause vision obstruction. 4. Often associated with aging, genetics or eyelid ptosis.

5. Common in Finland and Russia

Key differences bet epicanthic Folds and " Hooded Eyelids": 1. Location: Hooded eyelids affect the upper eyelid, while epicanthic folds occur at the inner eye corner. 2. Cause: Hooded eyelids are often age-related, whereas epicanthic folds are primarily genetic. Some individuals may have both hooded eyelids and epicanthic folds. Surgical Procedures 1. Blepharoplasty (eyelid surgery): Addresses hooded eyelids. 2. Epicanthoplasty: Specifically reduces epicanthic folds.