Blepharophimosis ptosis epicanthus inversus syndrome clinical review and institutional case series

Purpose: To review the genetic basis, clinical assessment and surgical management of blepharophimosis–ptosis–epicanthus inversus syndrome (BPES), and critically describe an institutional case series.Materials and Methods: A targeted narrative literature update was undertaken, with bibliographic verification through PubMed-indexed records and accessible journal sources. The institutional component is described in the submitted manuscript as a retrospective review of 29 patients managed during 2013–2023. Its eligibility criteria, ethics documentation and patient-level dataset require confirmation.Results: The reported cohort comprised 16 females and 13 males, with a mean age of 8.8 years. All 29 patients underwent medial canthoplasty; 27 subsequently underwent frontalis suspension after 6–9 months. At a reported mean follow-up of 18 months, postoperative margin reflex distance 1 was 3.8 ± 0.5 mm; palpebral fissure height was 7.8 ± 0.9 mm in right eyes and 7.3 ± 0.8 mm in left eyes. The evaluable sample for each measurement was not stated. Paired baseline measurements, visual acuity change, amblyopia treatment outcomes, validated patient-reported outcomes and molecular testing results were unavailable for this revision.Conclusions: The available summary describes postoperative eyelid position but cannot establish functional benefit or superiority of a surgical sequence. Clinical management should prioritize visual development and individual anatomy. Genotype–phenotype predictions, especially for ovarian function, require cautious counseling.