Congenital Upper Eyelid Entropion in an Extremely Low Birth Weight Neonate: Early Surgical Correction to Prevent Corneal Injury

Congenital upper eyelid entropion is rare but can rapidly cause severe corneal morbidity in neonates if left untreated. In extremely low-birth-weight infants with multisystem anomalies, surgical intervention carries substantial risks, creating a balance between life-preserving caution and vision-preserving urgency. We report a case of early surgical correction in a late preterm neonate weighing 900g who presented with bilateral congenital upper eyelid entropion and right corneal ulceration. Surgical correction involved transposing the pretarsal orbicularis and levator aponeurosis complex, fixing it to the superior tarsal border to restore lamellar balance. Immediate postoperative bilateral eyelid eversion was achieved, resolving ocular irritation. At 4 months postoperatively, the eyelid position was stable without recurrence. Early surgical correction can safely restore lamellar balance and prevent irreversible corneal sequelae in fragile neonates.