Epicanthal folds

Plica palpebronasalis

An epicanthal fold is skin of the upper eyelid that covers the inner corner of the eye. The fold runs from nose to the inner side of the eyebrow.

Causes

Epicanthal folds may be normal for people of Asian descent and some non-Asian infants. Epicanthal folds also may be seen in young children of any race before the bridge of the nose begins to rise.

However, they may also be due to certain medical conditions, including:

Down syndrome
Fetal alcohol syndrome
Turner syndrome
Turner syndrome
Turner syndrome is a rare genetic condition in which a female does not have the usual pair of X chromosomes.
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Phenylketonuria (PKU)
Phenylketonuria
Phenylketonuria (PKU) is a rare condition in which a baby is born without the ability to properly break down an amino acid called phenylalanine....
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Williams syndrome
Williams syndrome
Williams syndrome is a rare disorder that can lead to problems with development.
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Noonan syndrome
Noonan syndrome
Noonan syndrome is a disease present from birth (congenital) that causes many parts of the body to develop abnormally. In about 50% of cases, it is ...
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Rubinstein-Taybi syndrome
Rubinstein-Taybi syndrome
Rubinstein-Taybi syndrome (RTS) is a genetic disease. It involves broad thumbs and toes, short stature, distinctive facial features, and varying deg...

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Blepharophimosis syndrome

Home Care

In most cases, no home care is needed.

When to Contact a Medical Professional

This trait is most often 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.

What to Expect at Your Office Visit

The provider will examine the child and ask questions about the medical history and symptoms. Questions may include:

Do any family members have Down syndrome or other genetic disorder?
Is there a family history of intellectual disability or birth defects?
Intellectual disability
Intellectual disability is a condition diagnosed before age 18 that includes below-average intellectual function and a lack of skills necessary for d...

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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.

Open References

References

Madan-Khetarpal S, Arnold G, Ortiz D. Genetic disorders and dysmorphic conditions. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 1.

Olitsky SE, Marsh JD. Abnormalities of the lids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 642.

Örge FH. Examination and common problems of the neonatal eye. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 95.

The face - illustration
The physical landmarks of the human face are very similar from one face to another.
The face
illustration
Epicanthal fold - illustration
An epicanthal fold is a skin fold of the upper eyelid covering the inner corner of the eye. It is often seen as a normal finding in very young children and is also common in people of Asiatic decent. An epicanthal fold can be an important diagnostic finding in conditions such as Down syndrome.
Epicanthal fold
illustration
Epicanthal folds - illustration
The epicanthal fold is the skin fold of the upper eyelid covering the inner corner of the eye, most usually seen in people of Asiatic descent.
Epicanthal folds
illustration

The face - illustration
The physical landmarks of the human face are very similar from one face to another.
The face
illustration
Epicanthal fold - illustration
An epicanthal fold is a skin fold of the upper eyelid covering the inner corner of the eye. It is often seen as a normal finding in very young children and is also common in people of Asiatic decent. An epicanthal fold can be an important diagnostic finding in conditions such as Down syndrome.
Epicanthal fold
illustration
Epicanthal folds - illustration
The epicanthal fold is the skin fold of the upper eyelid covering the inner corner of the eye, most usually seen in people of Asiatic descent.
Epicanthal folds
illustration

Self Care

Tests for Epicanthal folds

Review Date: 1/24/2023

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Health Library

Epicanthal folds

Causes

Turner syndrome

Phenylketonuria

Williams syndrome

Noonan syndrome

Rubinstein-Taybi syndrome

Home Care

When to Contact a Medical Professional

What to Expect at Your Office Visit

Intellectual disability

References

The face - illustration

The face

Epicanthal fold - illustration

Epicanthal fold

Epicanthal folds - illustration

Epicanthal folds

The face - illustration

The face

Epicanthal fold - illustration

Epicanthal fold

Epicanthal folds - illustration

Epicanthal folds

Self Care

Tests for Epicanthal folds

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