epicanthal fold

[OLDCOT]

My 6 yr old daughter has epicanthal folds in each eye. She is caucasian. She has a little bit of trichiasis near the inner canthi as well.  Her eyes have watered off and on and she somtimes complains that her eyes are scratchy.  None of the eye docs who have seen her have ever commented on the folds or her lashes.  I noticed the folds when she was born, but since no dr seemed concerned, I assumed it was ok.  They have become less noticeable as she has grown, but they are still distinctively there.

The other day she asked me to paint her toe nails.  I noticed for the first time that her 4th toe on each foot looked decidedly short.  After doing some research and looking at them more closely, I realize it's not that.... it is her 2nd and 3rd that are longer and slightly webbed.  These two physical traits are found in a condition called SLOS which is a genetic disorder, but the systemic failure it causes can be treated.  Now, honestly, if she has this it is extremely mild - almost negligible.  One of the manifestations is mental retardation and autistic traits at varying severity.  She is very bright but does have learning and behavior problems and at one time was evaluated for a condition that is on the autistic spectrum.  But all in all she is functional and progressing satisfactorily thru k'garten.  Even excelling in some areas.

All that to ask....  how common are epicanthal folds in caucasians in the absence of chromosonal defect?  I've done the typical armchair science research and learned just enough to scare myself.  If this can be a benign finding, I am going to make myself stop worrying.  But if it rare or non-existent without an underlying disorder, I will get her in to be tested.  If she does indeed have this problem, I want to have it dx'd so treatment can be initiated.

Thanks in advance for your patience with an ever worrying mom.  

[Ray T Oyakawa, MD]

I do not know.  See your pediatrician.


Dr. O.

[OLDCOT]

trying to load the foot pic, too