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An epicanthic fold or epicanthus [6] is a skin fold of the upper eyelid that covers the inner corner (medial canthus) of the eye. [3] However, variation occurs in the nature of this feature and the possession of "partial epicanthic folds" or "slight epicanthic folds" is noted in the relevant literature.
It is characterized by a prominent forehead, widely spaced eyes, an upturned nose, an underdeveloped mandible, dental hypoplasia, and patulous lips. [1] It can be associated with Williams syndrome and Donohue syndrome (leprechaunism). [2] [3]
Hippocratic facies – eyes are sunken, temples collapsed, nose is pinched with crusts on the lips, and the forehead is clammy; Moon face (also known as "Cushingoid facies") – Cushing's syndrome; Elfin facies – Williams syndrome, Donohue syndrome; Potter facies – oligohydramnios; Mask like facies – parkinsonism
A baby affected by Carpenter syndrome will also display malformations of the face. An individual affected by the syndrome may have broad cheeks, a flat nasal bridge, and a wide upturned nose with abnormally large nasal openings. Their ears will most commonly be low, unevenly set, and malformed in structure.
The nose may be small, wide, and upturned. The development of the ears and auditory system may be affected in people with Noonan's syndrome. This can result in low-set ears (in over 90%), backward-rotated ears (over 90%), thick helix (outer rim) of ear (over 90%), incomplete folding of ears, chronic otitis media (ear infections), and hearing loss.
Facial features such as almond-shaped eyes (supposed feature of Chinese origin) and prominent lips (supposed feature of African origin) are put forward as proof by supporters of alternative origins. Both almond-shaped eyes and snarled mouths are characteristic of the were-jaguar motif common in Olmec art.
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To detect the difference between strabismus and pseudostrabismus, clinicians use a flashlight to shine into the child's eyes. When the child is looking at the light, a reflection can be seen on the front surface of the pupil. If the eyes are aligned with one another, the reflection from the light will be in the same spot of each eye.