ETIOLOGY OF EYELID RETRACTION IN CHILDREN - A RETROSPECTIVE STUDY

Eyelid retraction in an adult occurs usually secondary to Graves' opht halmopathy, but in children the diagnosis is often obscure. To our kno wledge, there are no reports reviewing the relative frequency of the v arious etiologies of eyelid retraction in children. We reviewed the re cords of our Pediatric Service from 1976 to 1991 and identified 16 chi ldren with eyelid retraction. The eyelid retractions were unilateral i n 11 cases and bilateral in five cases, and were the result of five di fferent identifiable causes. Unilateral eyelid retraction was associat ed With congenital aberrant innervation of the third nerve (3), levato r fibrosis (2), hemangioma (1), hyperthyroidism (1), craniosynostosis (1) and Down syndrome (1). Bilateral eyelid retraction was associated with either hyperthyroidism (2) or bilateral optic nerve anomalies wit h vertical nystagmus (2). Seven of our 11 patients with unilateral ret raction had an identifiable etiology, and the remaining four patients had incomplete evaluations. Imaging studies were diagnostic in four of nine patients so studied. Based on our findings, we recommend thyroid studies in all patients with eyelid retraction without aberrant inner vation, and neuroimaging if thyroid function is normal.