Nonsurgical management of epiblepharon using hyaluronic acid gel.

A 4-month-old infant with epiblepharon of the right lower eyelid presented with medial eyelashes touching the corneal surface in primary gaze and resultant punctate epithelial keratopathy. Hyaluronic acid gel (Juvederm Ultra) 0.2 ml was injected in the suborbicular plane in the valley above the abnormal skin fold. Immediate out-turning of the eyelid margin was obtained, which persisted at 1-week, 1-month, and 4.5-month follow-up visits with no lash-corneal touch even in down gaze. Epiblepharon, which often self corrects with increasing age, can be effectively corrected with this minimally invasive nonsurgical option when it is symptomatic, and is a threat to the corneal health.