Unilateral congenital upper eyelid eversion in a newborn: Conservative management and outcome.

We present a rare congenital condition in a Persian newborn characterized by the unilateral everted upper eyelid. This report aimed to create awareness among neonatologists and ophthalmologists who are first-time viewers of this condition and lead them to choose the appropriate management.

CASE PRESENTATION

A male patient was born at 39 weeks of gestation by an uneventful cesarean section delivery with a birthweight of 3250 g. In the initial physical examination, the patient presented with eversion of the left upper eyelid and mild chemosis of the palpebral conjunctiva (Figure 1). The examination revealed an otherwise normal newborn. Diagnosis of congenital upper eyelid eversion (CUEE) was made, and the patient was managed with conservative treatment consisting in the application of topical antibiotics, artificial tears, and padding the exposed conjunctiva with sterile normal saline‐soaked gauzes. After 5 days, chemosis improved significantly and the patient could open his eye, but the eyelid continued to evert on crying. Then, topical steroid was applied. On the 14th day of the follow‐up visit, the lid retained its normal position, and in an ophthalmologic examination, both eyeballs were found normal (Figure 2).

FIGURE 1

Picture showing prolapsed left superior conjunctival fornix and chemosis resulting in eversion of the upper eyelid

FIGURE 2

Picture showing complete resolution of left upper eyelid eversion and chemosis on the 14th day after treatment

Congenital upper eyelid eversion is a rare condition of unidentified etiology. It has a higher prevalence in males and African populations. If the condition is diagnosed early and treated properly, it can be managed without surgery and serious ocular complications can be prevented. We report this case in a Persian newborn because CUEE can be highly alarming among healthcare workers if encountered for the first time.

CONFLICT OF INTEREST

None declared.

AUTHOR CONTRIBUTIONS

RF wrote and critically reviewed the manuscript and provided the images with descriptions. AF was the ophthalmologist on the case and made final edits.

ETHICAL APPROVAL

This report for a clinical image was conducted in accordance with the Declaration of Helsinki.

CONSENT

Written informed consent was obtained from the patient's parents.