Incidence and clinical characteristics of pediatric eyelid retraction

Abstract

Purpose: To describe the incidence and clinical characteristics of upper and lower eyelid retraction in children.

Methods: The medical records of all pediatric patients (<19 years of age) diagnosed with upper and/or lower eyelid retraction from January 1, 1976, through December 31, 2010, were retrospectively reviewed.

Results: A total of 85 patients were diagnosed during the 35-year period, of whom 15 were residents of Olmsted County, Minnesota, yielding an annual age- and sex-adjusted annual incidence of 1.38 per 100,000 persons (95% CI, 0.70-2.05), or 1 in 72,463. Upper eyelid retraction was documented in 38 patients (45%; 24 unilateral and 14 bilateral); lower, in 25 (29%; 12 unilateral and 13 bilateral); and both upper and lower in 18 (21%; 3 unilateral and 15 bilateral). It was not recorded in 4 patients. The most common causes of eyelid retraction were thyroid eye disease (48 [56%]), primary congenital eyelid retraction (11 [13%]), and trauma (9 [11%]). Although there were no cases of visual impairment secondary to eyelid retraction, tearing, ocular surface irritation, and photophobia were noted in 38 patients (45%). Nineteen patients (22%) underwent surgical eyelid correction.

Conclusions: Pediatric eyelid retraction is relatively rare, occurring in approximately 1 in 72,000. The leading causes of childhood eyelid retraction in this cohort were thyroid eye disease, primary congenital eyelid retraction, and trauma. No visual disturbances due to eyelid retraction were noted, and approximately 1 in 5 patients required corrective eyelid surgery.

FIG 1.

Age at diagnosis of childhood eyelid retraction by sex (January 1, 1976 to December 31, 2010).