Why epicanthic fold

Monolids are common in people of East Asian heritage and are also associated with some diseases and conditions, including Down syndrome. Also know as an epicanthal fold, monolids are a piece of skin on the eyelid that runs from the nose to the eyebrow. It gives the eyelid the appearance of having no crease. Monolids are perfectly normal and do not affect vision on their own.

Human eyes have both upper and lower eyelids. The upper and lower eyelids meet at the corners of the eyes, an area known as the canthus. Most people have a visible crease in the upper lid, which gives the upper eyelid the appearance of having two sections. This is known as a double lid. However, not everyone has this. Monolids, which have no crease, are common in people of East Asian descent, particularly Chinese or Korean heritage.

Without a crease, monolids appear as just one section. About half of Asians have a monolid. People who have a monolid have an epicanthal fold. This piece of skin covers the inner corner of the eye, reducing or eliminating the appearance of an eyelid crease.

Monolids can make the upper eyelid appear puffier or give the appearance of narrow eyes. Monolids are part of the normal variation of human appearance. They are usually caused by your genetics but can also be caused by medical conditions. People of Asian heritage are the most likely to have genes that cause an epicenthal fold, and therefore a monolid.

Specifically, people of Chinese, Korean, Mongolian, and Japanese heritage are most likely to have a monolid. There is a theory that the monolid gave an adaptive advantage to ancient Asians living in cold and windy climates like Mongolia by protecting the eye. In addition to people of Asian descent, some medical conditions can cause a monolid in people of any ethnicity.

These include:. There is also a condition known as blepharophimosis syndrome, which is characterized by a monolid, narrow eyes, and an epicanthal fold. There is nothing wrong with having a monolid, and many people embrace this eye shape. But some others want to give the appearance of having a double lid and wider eyes. This can be done with makeup, adhesives, or surgery.

If you are unhappy with your eye shape, you can try these, but remember that monolid eyes are beautiful just as they are. Asian makeup artists have their own tips and tricks to make monolid eyes look bigger or give the appearance of a crease. Eyeshadows and eyeliner can be used to draw attention to the eyes, making them more of a focal point on the face, even if they are narrow. Using bright colors, particularly on the inner eye, can help make a monolid eye pop, makeup artists say. Some people with monolids choose to use tape or glue to give the appearance of having a double lid.

The adhesives are meant to create an artificial crease in the eye temporarily, giving it the appearance of a double lid or wider eye. The histologic cross section of the epicanthal fold could be divided into outer skin, a central core structure, and inner skin.

The core is a combination of muscle fibers and fibrotic tissue. This fibromuscular core should be removed by the surgeon in removal or reconstruction of the epicanthal fold. Surgical correction is only occasionally required. Frequently a mild degree of epicanthus is observed in children and is generally temporary as the folds disappear with further development of the nose and mid facial bones.

However, epicanthus inversus rarely resolves with growth and will typically require surgical correction [7]. Surgical treatment for most isolated epicanthus is typically achieved with transposition flaps, such as a Y-V-plasty or Z-plasty. In Asian patients, epicanthus tarsalis may be eliminated with a subcutaneous epicanthoplasty, Y-V-plasty, or modified Z-plasty which may include upper lid crease formation.

Create account Log in. Main page. Getting Started. Recent changes. View form. View source. Epicanthal Folds From EyeWiki. Jump to: navigation , search. Enroll in the Residents and Fellows contest. Enroll in the International Ophthalmologists contest. Residents and Fellows contest rules International Ophthalmologists contest rules. The epicanthal fold is the skin fold of the upper eyelid covering the inner corner of the eye, most usually seen in people of Asiatic descent.

Epicanthal folds may be normal for people of Asiatic descent and some non-Asian infants. Epicanthal folds also may be seen in young children of any race before the bridge of the nose begins to rise.

This trait is most often found before or during the first well-baby exam. Call your health care provider if you notice epicanthal folds on your child's eyes and the reason for their presence is unknown.

The provider will examine the child and ask questions about the medical history and symptoms. Questions may include:. A child who is not Asian and is born with epicanthal folds may be examined for additional signs of Down syndrome or other genetic disorders. Madan-Khetarpal S, Arnold G. Genetic disorders and dysmorphic conditions. Philadelphia, PA: Elsevier; chap 1.