Entropion

What is entropion?

Entropion is a medical condition in which the eyelid (usually the lower lid) folds inward. It is very uncomfortable, as the eyelashes constantly rub against the cornea.

The upper or lower eyelid can be involved, and one or both eyes could be affected. When entropion occurs in both eyes, this is known as "bilateral entropion." Trachoma infection could cause scarring of the inner eyelid, which could cause entropion. In human cases, this condition is most common to people over 60 years of age.

Four basic anatomic defects which could lead to entropion:

  1. Horizontal lid laxity
  2. disinsertion or attenuation of retractors
  3. preseptal orbicularis overiding the pretarsal orbicularis muscle
  4. enophthalmos

 

Patients also find relief by pulling the lower eyelid away from the eye

 

Forms of Entropion

  • Congenital
    • rare
    • differentiate from epiblepharon
    • treat by excising skin and orbicularis below eyelid margin
  • Acute Spastic
    • due to ocular inflammation and irritation
    • Treat underlying disease or quickert suture
  • Involutional entropion
    • Etiologies  
      • laxity or defect of the lower eyelid retractors (involutional=senile), due to lid retratctor dehiscence of the lower eyelid retractors (analogue of mueller's muscle) or of capsulopapebral fascia (analogue of levator)
      • horizontal eyelid laxity
      • preseptal orbicularis override
      • enophthalmos
    • Treatment
      • Thermal cautery
      • quickert suture
      • re-attachment of lower eyelid retractors
      • full thickness horizontal eyelid lid splitting and marginal rotation
      • orbicularis muscle tightening procedures
      • horizontal lid shorteing
      • tarsal strip

PRE/POST PHOTOS

EtiologyCicatricial entropions

    • trauma
    • inflammation
    • pemphigus
    • pemphigoid
    • stevens-johnson syndrome
    • trachoma
  • Treatment
    • contact lenses
    • epilation
    • lubrication
    • mucous membrane graft
    • scleral grafts
Procedures
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