This refers to shortening of the horizontal palpebral fissure without pathologic changes in the eyelids. The palpebral fissure, normally 28-30 mm wide, may be reduced to half that width. Blepharophimosis is a rare disorder that is either congenital or acquired (for example, from scar contracture or aging). As long as the center of the pupil remains unobstructed despite the decreased size of the palpebral fissure, surgical enlargement of the palpebral fissure (by canthotomy or plastic surgery) has a purely cosmetic purpose.

22 2 The Eyelids 2.3.4 Ankyloblepharon

This refers to horizontal shortening of the palpebral fissure with fusion of the eyelids at the lateral and medial angles of the eye. Usually, the partial or total fusion between the upper and lower eyelids will be bilateral, and the palpebral fissure will be partially or completely occluded as a result. Posterior to the eyelids, the eyeball itself will be deformed or totally absent. Ankylo-blepharon is frequently associated with other skull deformities.

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