Epicanthal Folds in Fetal Alcohol Syndrome

Epicanthal folds is a harmless condition in which patient have skin folds of upper eyelid. These skin folds lean downward specially to inner corner of eye. It is a congenital disorder which may occur due to uneven or mal distribution of skin tissues during development of fetus. So many other congenital diseases like down syndrome and fetal alcohol syndrome may also lead to epicanthal folds. Epicanthal folds are normally present in asians, korean, chinese and japanese population. Epicanthal folds usually present in newborns but they disappear after 3 to 6 weeks of gestation period. But it still persists after that time period then there may be a disease behind it. Fetal alcohol syndrome is one of those diseases. In fetal alcohol syndrome, fetus developed abnormally due to over consumption of alcohol by mother during pregnancy.

Due to alcohol consumption during pregnancy, complications occur and cause further problems in delivery. Fetal alcohol spectrum disorder is another term used to describe fetal alcohol syndrome. When alcohol is consumed by mother during pregnancy, it actively crosses placental barrier and causes harm to fetus both physically and mentally. Amount and frequency of alcohol consumed effects development. During 1st trimester of pregnancy, vital organs start developing and if mother consume alcohol in this time period, it may cause serious problem to fetus. Child may born abnormal both physically and mentally. Oxygen utilization in blood is decreased by excessive alcohol presence which may lead to death.

The signs and symptoms of fetal alcohol syndrome have prominently eye disorders. These eye disorders primarily involve epicanthal folds. Over consumption of alcohol leads to abnormality in eye development and skin tissue distribution causing epicanthal folds. So fetal alcohol syndrome is considered a cause behind epicanthal folds appearance. Along with epicanthal folds, short palpebral fissures are also present. Child appear like flattened facial features and is considered a most common feature of fetal alcohol syndrome. Telecanthus may occur (greater distance between two corners of eye).

In fetal alcohol syndrome these all features may appear but epicanthal folds are the most prominent one and common. Nose may appear flat due to mal-distribution of skin tissues during developement. In fetal alcohol syndrome, epicanthal folds do not disappear on its own after gestation period. So treatment is required to make it normal.

Epicanthal folds are considered a diagnostic parameter for fetal alcohol syndrome. Appearance of epicanthal folds with other eye and lens abnormality and flattened nose confirm the presence of fetal alcohol syndrome. Treatment involves surgical removal of skin tissues of epicanthal folds. The inner most layer of medial canthus is removed with a surgery named epicanthoplasty. Eye structure is corrected in this surgery.

There are also other surgeries which are performed according to intensity and type of epicanthal folds involved. In fetal alcohol syndrome, epicanthal folds are usually corrected with epicanthoplasty because usually upper eyelid of eye is involved in epicanthal folds. But epicanthoplasty leaves mark of cut so most the people do not prefer this surgery.