What is a canthal tilt?

Canthal tilt refers to the angle formed by the palpebral fissures (the openings between the eyelids) in relation to a horizontal line. It's essentially the slope of the eyes. There are two types:

• Positive Canthal Tilt: The outer canthus (the outer corner of the eye) is higher than the inner canthus (the inner corner of the eye). This creates an upward slant to the eyes, often described as "upswept" or "almond-shaped." It's considered a common and generally aesthetically pleasing feature.

• Negative Canthal Tilt: The outer canthus is lower than the inner canthus. This creates a downward slant to the eyes. While considered less common in Western aesthetics, it's still a naturally occurring variation.

Factors influencing canthal tilt:

• Genetics: Primarily determined by heredity.
• Age: The angle can change slightly with age due to sagging skin and muscle tone.
• Facial expressions: Temporary alterations can occur due to muscle contractions.

Clinical Significance:

While primarily a cosmetic feature, extreme negative canthal tilt can sometimes be associated with certain genetic syndromes or conditions. It's rarely a significant clinical concern on its own, but might be noted as part of a broader assessment.

Cosmetics and Surgery:

Canthal tilt is a factor considered in cosmetic surgery, particularly blepharoplasty (eyelid surgery). Surgeons can adjust the position of the outer canthus to create a more positive tilt if desired, though this is a relatively complex procedure.

In short, canthal tilt is a natural variation in eye shape, with positive tilt being more common and generally perceived as aesthetically appealing. Extreme variations might be associated with other conditions, but it's not typically a cause for concern in itself.