This young boy came to my clinic because of a long-standing history of right ocular irritation. The vision was also slightly reduced (6/12). On examination, he was noted to have absent right double eyelid (skin crease) and a left well-formed double eyelid (skin crease). The eyelashes in the right eye are pushed downward by the skin causing them to rub against the eye and hence the irritation. The irritation was abolished when the eyelid was lifted.
Right absent skin crease causing misdirection of the eyelashes.
To lift the eyelashes, I create a double eyelid (skin crease) using the interrupted suture technique. The procedure concentrated mainly on the nasal aspect of the eyelid (where eyelash misdirection was the most severe).
The ocular irritation improved instantly after the procedure. The post-operative picture was taken at 3 months showing well-formed double eyelids and the eyelashes are now pointing outward instead of inward and downward.