Bilateral Congenital Upper Eyelid Eversion in Neonates with Lamellar Ichthyosis

Background: Bilateral congenital upper eyelid eversion is a rare but visually alarming condition that presents at birth and is often associated with systemic disorders such as lamellar ichthyosis. The condition, if not managed appropriately, can lead to serious ocular complications, including exposure keratopathy and infection. Purpose: The aim of this article is to present a case series of five neonates diagnosed with bilateral upper eyelid eversion associated with lamellar ichthyosis and to highlight the importance and effectiveness of early conservative management. Case Series: This case series includes five neonates who presented with bilateral upper lid eversion and clinical signs of lamellar ichthyosis. Each infant was managed conservatively with combinations of topical antibiotics, lubricants (hydroxypropylmethylcellulose 0.3% drops and 2% ointment), hypersaline eye drops and hypertonic saline-soaked gauze patching. Clinical outcomes including resolution of chemosis, lid eversion and prevention of corneal complications were documented. None required surgical intervention, and no long-term ocular complications were observed. Conclusion: Bilateral upper lid eversion in neonates with lamellar ichthyosis, though rare, can be effectively managed with prompt and consistent conservative treatment. Early recognition and multidisciplinary care are critical in preventing vision-threatening complications and avoiding unnecessary surgical procedures.