Refractive Changes in Epiblepharon

Purpose: To study the prevalence of astigmatism in patients with epiblepharon and keratopathy and to determine if astigmatism was influenced by surgical correction.

Design: This is a retrospective review of 182 eyes of 91 patients who were diagnosed with significant epiblepharon at the National University Hospital, Singapore.

Methods: Demographic data, best-corrected visual acuity, refractive error at presentation and annually thereafter, presence of amblyopia, severity of keratopathy, and nature of surgical intervention if any were recorded.

Results: Mean age of the patients was 7.23 +/- 6.43 years. 52.2% of patients had astigmatism of 1 diopter (D) or more (range, -0.5 to -4.0 D), and the astigmatism was largely with-the-rule. There was no significant association between severity of keratopathy and astigmatism. Nine percent of patients had amblyopia after spectacle correction and all had significant astigmatism. A total of 70.3% of patients underwent surgery and mean time to surgery was 12.2 +/- 13.1 months after diagnosis. Mean age to surgery was 7.5 +/- 7.12 years. Comparison of pre- and postoperative astigmatism in patients younger than age 5 at the time of surgery showed no significant changes in astigmatism at one to two years of follow-up.

Conclusions: There was high prevalence of astigmatism in patients with epiblepharon (52.2% had 1 D or more of astigmatism). A total of 9% of patients had amblyopia from astigmatism. Surgery did not seem to affect astigmatism especially in young children. Possibility of amblyopia from astigmatism must be borne in mind while treating children with epiblepharon.