Eye: The most obvious change is darkening around the palpebral fissure.

It is usually present in the palpebral fissure.

Small palpebral fissures - Eye width decreases with increased prenatal alcohol exposure.

Palpebral fissure is the anatomic name for the separation between the upper and lower eyelids.

Both the vertical and horizontal palpebral fissures (eyelid opening) are shortened.

Downward-slanting Palpebral fissures (openings between the upper and lower eyelids)

Widening of the palpebral fissure on attempted abduction.

Eyes are upslanting and show palpebral fissures, hypertelorism, and strabismus.

This results in the relaxation of the tarsal fold allowing tissue to slack over the palpebral fissure.

Downward slanting palpebral fissures (separation between upper and lower eye lids)

Affected individuals are dysmorphic with macrodolichocephaly, downslanting palpebral fissures and a pointed chin.

They have low-set, abnormal ears, slanting palpebral fissures and a flat nasal bridge.

Swollen conjunctive protruded through the palpebral fissure.

A canthorrhaphy is suturing of the outer canthus to shorten the palpebral fissure.

This reduces the palpebral fissure (eyelid separation), ideally leading to a reduction in tear evaporation.

Swelling of the conjunctiva (chemosis) is seen along the corners of the eye (palpebral fissures).

Marginal myotomy of levator palpebrae muscle can reduce the palpebral fissure height by 2-3 mm.

Tarsorrhaphy is a procedure in which the eyelids are partially sewn together to narrow the opening (i.e. palpebral fissure).

External examination of eyes consists of inspection of the eyelids, surrounding tissues and palpebral fissure.

The small palpebral fissure makes the eye look sunken in on the affected side, but the position of the globe in the orbit remains virtually unchanged.

Affected individuals may also have unusually short eyelid folds (palpebral fissures), flared eyebrows, a small lower jaw (mandible), and prominent ears.

The absence of the eye will cause a small bony orbit, a constricted mucosal socket, short eyelids, reduced palpebral fissure and malar prominence.

Additional features of the syndrome include downward slanting palpebral fissures, malar hypoplasia, malformed ears and a broad nasal ridge.

Retraction of the eyeball into the socket on adduction, with associated narrowing of the palpebral fissure (eye closing)

The eponymous Dalrymple's sign is named after him, which is an abnormal wideness of the palpebral fissures in exophthalmic goiter.