title: A Review of Eyelid Margin Malpositions: A Unique Spectrum in a South-East Asian Tertiary Hospital.
abstract: OBJECTIVE
  Due to the anatomical differences between the Asian and non-Asian eyelid, the authors hypothesize a different spectrum of eyelid margin malposition conditions seen in Singapore as compared with a predominant Caucasian population. The purpose of the study is to describe the spectrum of eyelid margin malpositions that were operated in a South-East Asian Tertiary Hospital.
  
  
  METHODS
  Retrospective study involving all patients who required surgery for eyelid margin malpositions over a 2-year period. The etiology and ethnic spread of patients were analyzed for each eyelid margin malposition.
  
  
  RESULTS
  A total of 249 eyelids (144 patients) were analyzed. There were 127 Chinese (88.2%), 8 Malays (5.6%), 6 Indians (4.2%), 2 Indonesians (1.4%), and 1 Korean (0.7%). Epiblepharon (53.4%) was the commonest surgery performed, followed by entropion (25.7%) and ectropion (20.9%). Among patients with epiblepharon and entropion, Chinese patients formed the overwhelming majority (>95%). There were no Eurasians or Indians who presented with epiblepharon or entropion. Among patients with ectropion, there was a higher representation of Indian patients (16.7%).
  
  
  CONCLUSIONS
  This study shows that the spectrum of eyelid margin malpositions in Singapore is unique and that developmental epiblepharon remains the commonest eyelid margin malposition requiring surgery. In terms of involutional eyelid margin malpositions, entropion is more common than ectropion, especially among the Chinese. The similarity in terms of eyelid involvement and ethnic distribution of both epiblepharon and involutional entropion suggests that there is a common factor in both these conditions, which the authors infer is due to the unique anatomy of the Asian eyelid.
authors.affiliation: *Department of Ophthalmology, National University Health System; and †Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces, Singapore.
authors.forename: Benjamin Boon Chuan
authors.initials: BB
authors.lastname: Tan
authors.forename: Vanessa Naseem
authors.initials: VN
authors.lastname: Mansurali
authors.forename: Gangadhara
authors.initials: G
authors.lastname: Sundar
authors.forename: Shantha
authors.initials: S
authors.lastname: Amrith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004483:Ectropion / Q000601:surgery*; D004774:Entropion / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore; D062606:Tertiary Care Centers; D055815:Young Adult