In 1888 Berry1 described symmetric notches in the outer portion of the lower lids in a mother whose daughter had a similar defect in one lower eyelid. Although Berry did not examine the mother's brother, the latter reputedly had a similar defect in one eye. The affected child's brother had no ocular defect but a harelip, and her older sister showed no clinical defects.
In 1900 Treacher Collins2 recorded 2 cases of symmetric congenital notching in the outer part of each lower lid associated with clinical evidence of defective development of the malar bones. The family history was negative for the condition in 1 case and was not mentioned in the other.
In 1927 Isakowitz3 described a similar case of symmetric notching of the outer portion of each lower lid. He stated the opinion that these defects were probably colobomas. Although he did not examine the father