We all love big eyes and double eyelids, but not everyone is so lucky. Sometimes, small eyes and single eyelids can have a unique charm and a different taste from others if they match well with facial contours and features. From a physiological point of view, single eyelids and double eyelids are both normal and basically indistinguishable. But there is a kind of small eyes, you should pay special attention, because this may be a disease. What you think of small eyes may be like this. But the small eyes I’m talking about are actually like this. So, what you think are small eyes are not necessarily really small, eyes that are too small are also a disease! His or her eyes look like a short slit, and you can’t even see the pupil. This is microphthalmia, a congenital disorder. Microphthalmia, also known as Komoto’s syndrome, is an autosomal dominant disorder with narrow lids and ptosis-inverted canthus syndrome. The appearance of the syndrome is characterized by complete bilateral severe ptosis, inverted canthus, lid fissure length generally <20 mm (normal length 25-30 mm, width 7-12 mm), markedly widened medial canthal spacing, and low nasal dorsum. Some have a combination of microphthalmia, nystagmus, inversion of the eyelid, and strabismus, which can affect visual development and manifest hypermetropia if it forms an excessive masking of the pupil. Patients with microphthalmia syndrome look unattractive and often have a strong desire to have bright, large eyes through double eyelid surgery. However, with microtia syndrome, it is not possible to just have double eyelid surgery. You need to choose the right time to have a comprehensive plastic surgery according to your situation so that you can achieve the best possible results. If the child has amblyopia or refractive error, the surgery should be done earlier depending on the actual situation. The surgery is performed in two stages: the first surgery to correct the canthus and widening of the medial canthus, and the second surgery to correct the ptosis 3-6 months later. Surgical methods 1. Mild lid fissure shortening: inner canthoplasty with correction of the medial canthus. 2. Lid fissure too short: inner canthoplasty combined with external canthoplasty. 3. Ptosis correction: usually severe, usually using frontalis suspension. Small lid fissure syndrome affects not only appearance, but also psychological health development, vision development, and daily learning and life. Therefore, patients and their families with congenital microtia should not hesitate to go to a regular medical institution for treatment.