Palpebral slant - eye

Alternative names
Mongolian slant

The direction of the slant of a line drawn from the outer corner of the eye to the inner corner is called the palpebral slant.

The palpebra are the upper and lower eyelids which, viewed together, make up the shape of the eye. A line drawn from inner corner to outer corner determines the slant of the eye, or palpebral slant. Slanting and retention of the epicanthal fold are normal in persons of Asian descent.

Abnormal slanting of the eye may be associated with some genetic disorders and syndromes. The most commonly recognized syndrome associated with an abnormal palpebral slant is Down syndrome. A fold of skin (epicanthal fold) is often present in the inner corner of the eye in Down syndrome as well.

Common Causes

  • Isolated incidence (not associated with any other defect)  
  • Down syndrome  
  • Fetal alcohol syndrome  
  • Other genetic disorders

Home Care
There is no special care for this sign. Instead, care must be appropriate for the particular condition of which an abnormal palpebral slant is a sign.

Call your health care provider if

  • Your infant has abnormal facial features  
  • You are concerned about your infant’s ability to move the eyes  
  • You notice any abnormal color, swelling, or discharge from the eyes

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting palpebral slant may include:

  • What is the slant (does the outer corner slant upward or downward)?  
  • What other symptoms are also present?

Physical examination may include:
An infant with an abnormal palpebral slant generally has other symptoms and signs that, when taken together, define a specific syndrome or condition. Diagnosis of that condition will be based on a family history, medical history, and a thorough physical evaluation.

Diagnostic tests that may be performed are:
Laboratory studies such as chromosome studies, enzyme assays, x-rays, and metabolic studies may be ordered to confirm the presence of a suspected disorder.

After seeing your health care provider:
If a diagnosis was made by your health care provider of the cause of an unusual palpebral slant, you may want to note that diagnosis in your personal medical record.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.