Short palpebral fissure
Page most recently updated 7 September 2026
This page focuses on short palpebral fissure as a morphologic feature of conditions that may also be associated with psychiatric manifestations, such as psychosis, mania, autism spectrum disorder, ADHD, OCD, and self-injurious behaviours. The page begins with a clinical definition of short palpebral fissure based on the standardized Elements of Morphology terminology, together with visual examples from the same source. This is followed by a list of conditions in which short palpebral fissure has been described in association with psychiatric manifestations.
Of note, to optimize clinical utility, the list does not include conditions associated with intellectual disability in the absence of other psychiatric features.
Each condition listed below is linked to a dedicated page within this resource. These pages describe the psychiatric manifestations associated with each condition, as well as other morphologic and broader clinical features, allowing the differential diagnosis to be considered from multiple perspectives.
Short palpebral fissure
Image credit: National Human Genome Research Institute (NHGRI), Elements of Morphology.
Definition
Subjective: Apparently reduced length of the palpebral fissure.
Objective: Distance between the medial and lateral canthi is more than 2 SD below the mean for age.
Note: Decreased palpebral fissure length may be accompanied by a decreased vertical distance between the upper and lower eyelid, which gives the eyes a more slit-like appearance and may give the appearance of ptosis, but this should be considered separately if it is present. Severe shortening of the palpebral fissures leads to Blepharophimosis (marked narrowing of the eye opening).
Conditions with potential psychiatric associations
Selected references and further reading — Morphologic lens
Allanson JE, Biesecker LG, Carey JC, Hennekam RCM. Elements of morphology: introduction. Am J Med Genet A. 2009;149A(1):2-5.
Hennekam RCM, Biesecker LG, Allanson JE, Hall JG, Opitz JM, Temple IK, Carey JC; Elements of Morphology Consortium. Elements of morphology: general terms for congenital anomalies. Am J Med Genet A. 2013;161A(11):2726-2733.
Jones KL, Jones MC, del Campo M. Smith's recognizable patterns of human malformation. 8th ed. Philadelphia: Elsevier; 2021.
Reardon W. The bedside dysmorphologist: a guide to identifying and assessing congenital malformations. 2nd ed. Oxford: Oxford University Press; 2016.