Indian Journal of Ophthalmology

CASE REPORT
Year
: 1984  |  Volume : 32  |  Issue : 1  |  Page : 41--43

Euryblepharon


SM Betharia, Y Dayal, RC Nayar 
 Dr. RP. Centre for Ophthalmic sciences, AIIMS, New Delhi, India

Correspondence Address:
S M Betharia
Lecturer, R.P. Centre, AIIMS, New Delhi-110 029
India




How to cite this article:
Betharia S M, Dayal Y, Nayar R C. Euryblepharon.Indian J Ophthalmol 1984;32:41-43


How to cite this URL:
Betharia S M, Dayal Y, Nayar R C. Euryblepharon. Indian J Ophthalmol [serial online] 1984 [cited 2021 Apr 10 ];32:41-43
Available from: https://www.ijo.in/text.asp?1984/32/1/41/27368


Full Text

Euryblepharon is a rare congenital anomaly in which there is symmetrical enlarge­ment of the palpebral aperture associated with large eyelids.[2],[8]

The average lid fissure lengths vary with age from 18.35 mm at birth to 29.68 mm at 24­26 years by various authors.[2],[9] some authors[7] give the measurement of normal palpebral aperture vis-a-vis the age as 18.5 to 19 mm X 10 mm (new born); 24-25 mm X 13 mm (Infant). 28-30 mmX14-15 mm (adult) and 28X11-12 mm (old age).

This is the first case report in a total of 306 lid anomaly cases seen at this centre from 1975-79. It describes certain peculiarities of the anomaly seen and the correction of the anomaly by Goldstein's modification of lateral canthoplasty.

 CASE REPORT



The patient, V.K, 23 year Male attended the RAPCOS Hospital with complaint of watering from both eyes. The local ocular examination showed symmetrical enlargement of the palpebral aperture. The lateral can thus area showed a depression lined by con­junctiva on its floor limited by globe medially and lateral can thus laterally. There were tears accumulated in this "lacus lacrimal is LATERALIS;; and were constantly dubbing over. There was congestion of conjunctiva laterally. The lacrimal puncta were well apposed and the lacrimal passages patent. There was no other ocular or systemic anomaly found.

Family members: The various measure­ments of the palpebral apertures are enumerated in [Table 1]. The ocular and sys­temic examination was essentially normal and there were no symptoms.

The patient V.K underwent Goldstein's modification of lateral canthoplasty [Figure 1][Figure 2]. The postoperative period was uneventful and there was no more watering from the eyes.

 DISCUSSION



This case of Euryblepharon with `lacus lac­rimalis lateralis" is peculiar in causing symptoms of epiphora. The possible mechanism appears to be stasis of secretion of tears with infection (congestion in lateral conjunctiva) would cause reflex increased secre­tion of tears which tend to overflow. We believe the presence of lacus lacrimalis lateralis as essential for the euryblepharon to be symptomatic as the rest of family members though Euryblepharon but none had problem of epiphora. However, the obliteration of the lacus lacrimalis lateralis by a lateral cantho­plasty would relieve the patient of the epiphora as shown in this case helps to sub­stantiate the hypothesis of stasis, infection and reflex increased secretion.

We have found both vertical and horizon­tal enlargement of palpebral-apertures.

We advocate the clinical classification of euryblepharon into complete and incomplete forms, wherein both vertical and horizontal enlargement occur in the complete form and only horizontal enlargement in the incom­plete form.

As far as heredity is concerned it shows autosomal dominant features. In our study the mother and all the 4 children show euryblepharon either in complete or incom­plete forms (See family tree & [Figure 3].[11]

References

1Desmanres, LA., 1854: Triate The 'Onque et Poatique des maladres, des Yeu'x, Vol p 468 Paris.
2Duke Elder S., 1964: System of Ophthalmology Vol. 3, pt. 2 p 841 Kimpton, London.
3Duke Elder S, and Cook, C. 1963: Ide, Vol. 3, Pt. p. 310.
4Gupta, J.S. and Kumal, K.,. 1968: Amer. J. Opthalmol., 66, 554
5Gupta, AX Rama Murthy, S., Sukla, K, 1972: J. Paed. Ophthalmol., 9: 173
6Last, R.J., 1968: Eugene Wolff's Anatomy of the Eye and Orbit, 6th Ed. p. 203, Lewis, London.
7Lindberg, J.G., 1928: Klin. Kbl. Augen Heilk 81. 665.
8Kerpert, J.A., 1975: Brit. J. Ophthal. 59: 57-58.
9Waardenburg, P.J., Franceschctti, A. and Klein, D., 1961: Genetics and Ophthalmology, Vol. 1, p. 253', Black­well Scientific Publications, Oxford
10Wolter, JR., 1972: J. Paed. Opthal., 9: 135.
11Warwick, R and Williams, P.L., 1973: Grey's Anatomy 35th Ed. p. 497, Longman, Edinburgh.