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Epicanthal fold

Epicanthal folds

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An epicanthal fold is skin of the upper eyelid -- from the nose to the inner side of the eyebrow -- that covers the inner corner (canthus) of the eye.

The presence of an epicanthal fold is normal in people of Asiatic descent. An epicanthal fold is also common in children with Down syndrome. Epicanthal folds may also be seen in young children of any race before the bridge of the nose begins to elevate.

Epicanthal folds may be normal for people of Asiatic descent and some non-Asian infants. However, it may also be due to certain medical conditions, including:

• Down syndrome
• Fetal alcohol syndrome
• Turner syndrome
• Phenylketonuria (PKU)
• Williams syndrome
• Noonan syndrome
• Rubinstein-Taybi syndrome
• Blepharophimosis syndrome

There is usually no home care needed.

This trait is usually found before or during the first well-baby exam. Call your health care provider if you notice epicanthal folds on your child's eyes and the reason for their presence is unknown.

The health care provider will obtain a medical history and will perform a physical examination.

Medical history questions documenting epicanthal folds in detail may include the following:

• Family history
  • Are any family members affected with Down syndrome or other genetic disorder?
  • Is there any family history of mental retardation or birth defects?
• What other symptoms or abnormalities are also present?

A child who is not Asian and is born with epicanthal folds may be examined for additional signs of Down syndrome or other genetic disorders.

Plica palpebronasalis

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.