Congenital eyelid eversion with orbicularis spasm.

Eversion of the lids at birth is a rare condition of debated etiology. It has been attributed most frequently to birth trauma or to congenital lid hypotonia. Most reported cases have been treated by immediate taping of the lids or by surgery (tarsorraphy, intermarginal sutures, and/or plastic procedures). A prominent association with Down's syndrome has been noted. We report a normal infant, born by Caesarean section, with bilateral upper eyelid eversion which subsided spontaneously after treatment only with lubricants. A prominent spastic ectropion component was observed. Lid laxity appeared to be an effect rather than a cause of the eversion, and disappeared as the condition improved. Management should take into account the duration of total occlusion caused by this abnormality.