Plica palpebronasalis

Alternative names
Epicanthal folds

An epicanthal fold is skin of the upper eyelid (from the nose to the inner side of the eyebrow) that covers the inner corner (canthus) of the eye.


The presence of an epicanthal fold is normal in people of Asiatic descent. An epicanthal fold is also common in children with Down syndrome. Epicanthal folds may also be seen in young children of any race before the bridge of the nose begins to elevate.

Common Causes

  • Normal appearance (for people of Asiatic descent and some non-Asian infants)  
  • Down syndrome  
  • Turner syndrome  
  • Phenylketonuria (PKU)  
  • Williams syndrome  
  • Noonan syndrome  
  • Rubinstein-Taybi syndrome  
  • Blepharophimosis syndrome

Home Care

There is usually no home care needed.

Call your health care provider if

This trait is usually found before or during the first well baby exam. Call your health care provider if you notice epicanthal folds on your child’s eyes and the reason for their presence is unknown.

What to expect at your health care provider’s office

The health care provider will obtain a medical history and will perform a physical examination.

Medical history questions documenting epicanthal folds in detail may include the following:

  • family history       o Are any family members affected with Down syndrome or other genetic disorder?       o Is there any family history of mental retardation or birth defects?  
  • What other symptoms or abnormalities are also present?

A child who is not Asian and is born with epicanthal folds may be examined for additional signs of Down syndrome or other genetic disorders.

Johns Hopkins patient information

Last revised: December 4, 2012
by Amalia K. Gagarina, M.S., R.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.