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Epicanthal folds
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Epicanthal folds

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Plica palpebronasalis

An epicanthal fold is skin of the upper eyelid that covers the inner corner of the eye.  The fold runs from nose to the inner side of the eyebrow.  

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  • Considerations

    An epicanthal fold is normal in people of Asian descent.

    An epicanthal fold is also common in children with Down syndrome.

    Epicanthal folds may be seen in young children of any race before the bridge of the nose begins to rise.

  • Causes

    Epicanthal folds may be normal for people of Asiatic descent and some non-Asian infants. However, it may also be due to certain medical conditions, including:

    • Down syndrome
    • Fetal alcohol syndrome
    • Turner syndrome
    • Phenylketonuria (PKU)
    • Williams syndrome
    • Noonan syndrome
    • Rubinstein-Taybi syndrome
    • Blepharophimosis syndrome
  • Home Care

    There is usually no home care needed.

  • When to Contact a Medical Professional

    This trait is usually found before or during the first well-baby exam. Call your health care provider if you notice epicanthal folds on your child's eyes and the reason for their presence is unknown.

  • What to Expect at Your Office Visit

    The doctor or nurse will examine the patient and ask questions about the medical history and symptoms. Questions may include: 

    • Do any family members have Down syndrome or other genetic disorder?
    • Is there a family history of intellectual disability or birth defects?

    A child who is not Asian and is born with epicanthal folds may be examined for additional signs of Down syndrome or other genetic disorders.

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Review Date: 2/21/2013  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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