The Correlation between epiblepharon and obesity in Pediatric patients: a Retrospective Comparative Study

Background/Objectives: Epiblepharon is a common congenital eyelid anomaly in East Asian children, often associated with redundant skin and orbicularis oculi muscle overriding the eyelid margin. Recent studies have suggested that systemic factors such as body mass index (BMI) may contribute to its development. This study aimed to investigate the relationship between BMI and epiblepharon and to analyze the correlation between BMI and skin fold height as a marker of eyelid structural redundancy. Methods: This retrospective comparative study included 100 pediatric patients (54 males, 46 females) aged 3–13 years who underwent surgical correction for lower eyelid epiblepharon and 100 age-matched controls without the condition. Preoperative height, weight, and skin fold height were analyzed. BMI was calculated as weight (kg) divided by height (m²). Intergroup comparisons were performed using independent t-tests, and correlations between BMI and skin fold height were evaluated using Pearson’s correlation coefficient. Results: No significant differences in age or sex were found between groups. Among boys aged 7–10 years, BMI was significantly higher in those with epiblepharon than in controls (p < 0.05), whereas boys aged 3–4 years showed significantly lower BMI (p < 0.05). Higher BMI was significantly correlated with lower skin fold height (r = –0.410, p < 0.001), suggesting increased orbicularis muscle redundancy in obese children. Conclusions: Higher BMI may influence the development of epiblepharon by altering periorbital soft tissue structure. BMI should be considered during evaluation and surgical planning, and further longitudinal studies are warranted to elucidate age-dependent relationships between BMI and eyelid morphology.