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Blepharophimosis, ptosis, and epicanthus inversus syndrome
(often shortened to BPES)
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Reviewed November 2008
What is BPES?
Blepharophimosis, ptosis, and epicanthus inversus syndrome (also called BPES) is a condition that mainly affects the development of the eyelids. People with this condition have a narrowing of the eye opening (blepharophimosis), droopy eyelids (ptosis), and an upward fold of the skin of the lower eyelid near the inner corner of the eye (epicanthus inversus). In addition, there is 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.
People with BPES are at an increased risk of developing vision problems such as nearsightedness (myopia) or farsightedness (hyperopia). They may also have eyes that do not point in the same direction (strabismus) and lazy eye (amblyopia) affecting one or both eyes.
There are two types of BPES. Type I consists of the four major features of blepharophimosis, ptosis, epicanthus inversus, and telecanthus, plus premature ovarian failure. Premature ovarian failure causes a woman's menstrual periods to become less frequent and eventually stop before age 40. Premature ovarian failure can lead to difficultly conceiving a child (subfertiliy) or a complete inability to conceive (infertility). Type II consists of only the eyelid malformations.
How common is BPES?
The prevalence of BPES is unknown.
What genes are related to BPES?
Mutations in the FOXL2 gene cause BPES types I and II. The FOXL2 gene provides instructions for making a protein that is involved in the development of the eyelids and the ovaries before birth. The FOXL2 protein is also active in the ovaries throughout adult life.
Some FOXL2 gene mutations impair development of the eyelids only, while others also affect development of the ovaries. Mutations that affect the functioning of the FOXL2 protein in the eyelids and ovaries result in BPES type I. Mutations that affect the functioning of FOXL2 protein only in the eyelids result in BPES type II.
Approximately 12 percent of people with BPES do not have an identified FOXL2 gene mutation; the cause of the condition in these people is unknown.
Read more about the FOXL2 gene.
How do people inherit BPES?
This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder.
In some cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family.
Where can I find information about diagnosis or management of BPES?
These resources address the diagnosis or management of BPES and may include treatment providers.
General information about the diagnosis and management of genetic conditions is available in the Handbook. Read more about genetic testing, particularly the difference between clinical tests and research tests.
To locate a healthcare provider, see How can I find a genetics professional in my area? in the Handbook.
Where can I find additional information about BPES?
You may find the following resources about BPES helpful. These materials are written for the general public.
You may also be interested in these resources, which are designed for healthcare professionals and researchers.
What other names do people use for BPES?
What if I still have specific questions about BPES?
Where can I find general information about genetic conditions?
The Handbook provides basic information about genetics in clear language.
These links provide additional genetics resources that may be useful.
What glossary definitions help with understanding BPES?
amblyopia ; autosomal ; autosomal dominant ; blepharophimosis ; cell ; gene ; infertility ; lazy eye ; mutation ; myopia ; nearsightedness ; ovarian ; prevalence ; protein ; ptosis ; strabismus ; syndrome
You may find definitions for these and many other terms in the Genetics Home Reference Glossary.
See also Understanding Medical Terminology.
References (7 links)
The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? in the Handbook.