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Genetic and Rare Diseases Information Center (GARD)

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Blepharophimosis, ptosis, and epicanthus inversus syndrome type 1

Other Names for this Disease
  • Blepharophimosis syndrome type 1
  • Blepharophimosis, ptosis, epicanthus inversus with ovarian failure
  • BPES type 1
  • BPES with premature ovarian failure
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Your Question

Are there any support groups or networking opportunities for adults with blepharophimosis type 1?  Is there any information on procedures that can correct the appearance of persons with this condition?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is blepharophimosis, ptosis, and epicanthus inversus syndrome type 1?

Blepharophimosis, ptosis and epicanthus inversus syndrome type 1 (BPES I) is a condition, present at birth, that mainly effects the development of the eyelids.  People with this condition have narrowing of the eye opening (blepharophimosis), droopy eyelids (ptosis), an upward fold of the skin of the lower eyelid near the inner corner of the eye (epicanthus inversus), and an increased distance between the inner corners of the eyes (telecanthus).  Because of these eyelid malformations, the eyelids cannot open fully, and vision may be limited.  Blepharophimosis syndrome type 1 also causes premature ovarian failure (POF).  This condition is caused by mutations in the FOXL2 gene and is inherited in an autosomal dominant pattern.[1]
Last updated: 6/6/2011

How might Blepharophimosis syndrome type 1 be treated?

Management of blepharophimosis syndrome type 1 requires the input of several specialists including a clinical geneticist, pediatric ophthalmologist, eye plastic (oculoplastic) surgeon, endocrinologist, reproductive endocrinologist, and gynecologist.

Eyelid surgery should be discussed with an oculoplastic surgeon to decide on the method and timing that is best suited for the patient. Traditionally, surgical correction of the blepharophimosis, epicanthus inversus, and telecanthus (canthoplasty) is performed at ages three to five years, followed about a year later by ptosis correction (usually requiring a brow suspension procedure). If the epicanthal folds are small, a "Y-V canthoplasty" is traditionally used; if the epicanthal folds are severe, a "double Z-plasty" is used. Unpublished reports have indicated that advanced understanding of the lower eyelid position has allowed for more targeted surgery that results in a more natural appearance. [2] 

For a general explanation of these procedures and to locate an eye-care professional visit the Foundation of the American Academy of Ophthalmology and the National Eye Institute websites. To locate a surgeon through the American Society of Ophthalmic Plastic & Reconstructive Surgery click here.

Generally, premature ovarian failure (POF) is treated with hormone replacement therapy. There is no specific treatment for POF caused by blepharophimosis syndrome type 1. Hormone replacement therapy is generally estrogen and progesterone and sometimes also includes testosterone. Birth control pills are sometimes substituted for hormone replacement therapy. Although health care providers can suggest treatments for some of the symptoms of POF, currently there is no scientifically established treatment to restore fertility for women diagnosed with POF. Women with POF are encouraged to speak to a health care professional. If you wish to obtain more information and support, you can visit the International Premature Ovarian Failure Association[3]
Last updated: 6/6/2011

Are there any advocacy organizations for adults with Blepharophimosis syndrome type 1?

Yes, additional information and supportive resources for adults with Blepharophimosis syndrome type 1 are available from the following organizations:

PO Box 751112
Las Vegas, NV 89136
Toll-free: 1- 888-486-1209
Telephone: 702-769-9264
Web site:

AboutFace International
123 Edward Street Suite 1003
Toronto ON M5G 1E2
Toll-free: 1-800-665-FACE (800-665-3223)
Telephone: 416-597-2229
Fax: 416-597-8494
Web site:

Blepharophimosis, Ptosis, Epicanthus Inversus Family Network
SE 820 Meadow Vale Drive
Pullman WA 99163
Telephone: 509-332-6628
Web site

FACES: The National Craniofacial Association
PO Box 11082
Chattanooga TN 37401
Toll-Free: 1- 800-332-2373
Web site:

International Premature Ovarian Failure Association
PO Box 23643
Alexandria, VA 22304
Telephone: 703-913-4787
Web site:

Resolve: The National Infertility Association: Premature Ovarian Failure
1760 Old Meadow Rd. Suite 500
McLean, VA 22102
Telephone: 703-556-7172
Fax: 703-506-3266
Web site:

Lighthouse International
111 E 59th Street
New York, NY 10022-1202
Toll-free: 1-800-829-0500
Telephone: 212-821-9200
TTY: 212-821-9713
Fax: 212-821-9707
Web site:
Last updated: 9/23/2010