Unilateral congenital eyelid eversion: An unusual presentation

Abstract

Congenital eyelid eversion is a rare condition of unknown aetiology. It has a higher prevalence in males and African populations, particularly in west African countries. Eyelid eversion is thought to be caused by birth trauma and/or intrauterine factors in the presence of certain predisposing factors. These factors include a vertically short anterior lid lamellae or vertical elongation of the posterior lamellar, generalised tissue hyperelasticity, congenital elevator disinsertion, absence of levator muscle function and/or some other intrinsic lid abnormality. Once everted, irritation of the eye causes orbicularis muscle spasm. This acts as a sphincter resulting in conjunctival strangulation with venous congestion and stasis. Increasing venous congestion causes conjunctival oedema that worsens the eyelid eversion. Here, we present one of the first known cases of congenital eyelid eversion that was successfully treated with conservative measures in a South African setting.