Acquired Lower Eyelid Epiblepharon with Thyroid Associated Ophthalmopathy

Namju Kim

Purpose: To describe the clinical features of the acquired lower eyelid epiblepharon with thyroid associated ophthalmopathy (TAO), as well as to analyze the locational characteristics of the acquired lower eyelid epiblepharon with TAO compared with the congenital lower eyelid epiblepharon.

Methods: The medical records of TAO patients from 2005 to 2010 were reviewed. The prevalence of epiblepharon, clinical characteristics, and the associated signs such as exophthalmos, lower eyelid retraction and elevation limitation were evaluated. The extent of lower eyelid epiblepharon in TAO with epiblepharon patients were compared with that of congenital lower eyelid epiblepharon.

Results: Acquired lower eyelid epiblepharon was found in 42 patients (8.5%) out of total 494 TAO patients and they consisted of 19 unilateral cases (45.2%) and 23 bilateral cases (54.8%). TAO with epiblepharon group (34.2±13.5 years) was significantly younger than TAO without epiblepharon group (46.5±14.1 years) (p < 0.05, t-test). Lower eyelid retraction was more frequently accompanied with TAO with epiblepharon group (27 eyelids, 41.5%) than TAO without epiblepharon group (157 eyelids, 17.4%) (p < 0.05, Chi-square test). The proportion of center-involving epiblepharon was significantly high in TAO with epiblepharon group than in congenital epiblepharon group (P < 0.05, Chi-square test). The elevation limitation was more frequently accompanied with central type (10 eyelids, 50%) than medial (4 eyelids, 11.8%) or diffuse type (1 eyelid, 9.1%) in TAO with epiblepharon (p < 0.05, Chi-square test).

Conclusions: Epiblepharon is one of the frequent features of TAO. TAO patients of young age and with lower eyelid retraction are likely to develop epiblepharon. Acquired epiblepharon in TAO patient is likely to occur in the central part of the eyelid and in that case elevation limitation was frequently accompanied.