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The most severe phenotype, fetal alcohol syndrome, involves facial dysmorphism, growth deficits, and neurocognitive problems. The classic facial characteristics include short palpebral fissures, smooth philtrum, and thin upper vermillion.
The principal features of the disorder include growth deficiency; a characteristic pattern of minor malformations which is made up of subtle but distinct facial features including short palpebral fissures, maxillary hypoplasia, and a long smooth philtrum with a thin smooth vermilion border of the upper lip; and
FAS/FASD most commonly affects the Eyelids: Short palpebral fissures (smaller eyelid openings) Prominent Epicanthal folds (larger than normal fold of skin near the inner corner of the eye) Telecanthus (large distance between inner corners of the eyes) Fetal Alcohol Syndrome aapos.org glossary fetal-alcohol-syndrome aapos.org glossary fetal-alcohol-syndrome
Short palpebral fissures may well reflect a defect in forebrain development rather than being proportionally reduced in size as a reflection of microcephaly.
Strabismus (an eye turn) is present in 25 to 50 percent of children with FAS. Some other possible problems include cataracts (clouding of the lens) and nystagmus (involuntary rapid movements of the eye). Changes in the eyelids are common in FAS but may not hinder visual development.
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