Please click to enlarge.
Note what signs you see.
I (W. Wertelecki, M.D.) see a lower lid that sags outward or away from the eye exposing the inner eyelid – a sign that is called ectropion. I also see two depigmented spots on the iris (Brushfield spots). Of course, such patient would undergo general examination (which revealed multiple signs suggestive of Down syndrome).
Ectropion is not emphasized in reports concerning Down syndrome associated or not with trisomy 21 (21+). However, laxity of tissues in patients with Down syndrome is very common and is associated with ectropion. Ectropion and Down syndrome are also associated with “dry eyes” and ectropion is a cause of eye dryness and irritation (blepharitis). Again, blepharitis is likewise associated with Down syndrome. These circular statements may indicate that Down syndrome and ectropion are associated more frequent than reported in the clinical literature.
PERSPECTIVES, please see Down syndrome.