Congenital upper eyelid eversion is a rare condition more frequently seen in black infants and in Down’s syndrome. If recognised early, the condition can be managed conservatively without recourse to surgery. We highlight a case that presented late with severe sight threatening complications. Surgical intervention was consequently the only appropriate way to manage the patient.

Case report

A 7 month old black female was referred to the emergency room of the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia. She had a history of a white spot in the right cornea, and a right upper lid that had flipped up since birth.

She was born by breech delivery and was subsequently diagnosed as having Down’s syndrome. On examination she had complete eversion of the right upper lid with mild conjunctival chemosis. The lid could be repositioned with ease but when the child cried it reverted. There was a corneal opacity with a …