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Epiblepharon outcomes: comparing apples and oranges
  1. Petrina Tan1,
  2. Raman Malhotra2
  1. 1 Department of Ophthalmology, Ng Teng Fong General Hospital, National University Health Services, Singapore, Singapore
  2. 2 Corneo-plastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
  1. Correspondence to Raman Malhotra, Corneo-plastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, RH19 3DZ, UK; raman{at}ramanmalhotra.com

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Epiblepharon, a common occurrence among children of East Asian descent, is a congenital anomaly whereby a horizontal skin fold across the eyelid (upper or lower) overlaps the eyelid margin resulting in inturning of the eyelashes.1–3 This usually occurs in the presence of a normal eyelid margin position. Surgical treatment is indicated for patients with significant ocular irritation or keratopathy that has failed prior medical treatment or visually threatening astigmatism.4 5

There are two papers in this issue on the use of everting sutures to successfully treat mild to moderate cases of epiblepharon.6 7 Although the technique of everting sutures for epiblepharon treatment is not new, having been described by Quickert et al 8 in 1983, novel modifications by the above authors have improved the success and recurrence rates of epiblepharon using this principle. This provides useful insight as to how the majority of cases may be managed henceforth without the need for traditional incisional procedures.

The authors have also sought to classify the severity of epiblepharon based on an accepted grading system proposed by Khwarg and Lee9 prior to treatment and also set out strict inclusion criteria for their study. This no doubt has helped to increase success rates using everting sutures.

To paraphrase Lord Kelvin, ‘If you cannot measure it, you cannot improve it’.10 Establishing a common objective system for grading epiblepharon therefore is advisable to help determine the appropriate indications for surgery and the type of procedure required for each grade of severity. In addition, having an objective system of classification and surgical criteria will help make direct comparisons of outcomes between different treatment …

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