Ankyloblepharon filiforme adnatum (AFA) is a mild form of ankyloblepha
ron, in which there is partial thickness fusion of the central portion
of the lid margins, sparing the canthi. Although it can be seen as an
isolated sporadic congenital defect, it is important for pediatric op
hthalmologists to be cognizant of its possible association with a numb
er of anomalies. One infrequent, but nevertheless important associatio
n, is with trisomy 18. We present three cases of AFA in association wi
th trisomy 18, and emphasize the need for clinicians to search for oth
er abnormalities in a newborn presenting with AFA.