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Ocular System

Entropion

Inward rolling and rotation of lid margin to the globe.

 

Inward rolling and rotation of lid margin to the globe.


Etiology

Congenital entropion

  • Lower eyelid congenital entropion
  • Upper eyelid congenital entropion

Cicatricial entropion

Cicatricial contraction of the palpebral conjunctiva with/without associated distortion of the tarsal plate.
  • Trachoma
  • Membranous conjunctivitis
  • Chemical burn
  • Pemphigus
  • Stevens-Johnson syndrome (SJS)

Senile (involutional) entropion

Mechanical entropion

  • Phthisis bulbi
  • Enophthalmos
  • After enucleation or evisceration operation

Presentation

Trichiasis-like symptoms:

  • Foreign body sensation
  • Irritation
  • Lacrimation
  • Photophobia

Management

Congenital entropion:

May resolve spontaneously
  • Hotz Procedure

Cicatricial entropion:

Aims to alter direction, transplant and straighten the distorted lashes
  • Anterior lamellar resection
  • Tarsal wedge resection
  • Modified Ketssey’s Operation (transposition of tarsoconjunctival wedge)
  • Posterior lamellar graft

Senile entropion:

  • Wies operation (transverse lid split and everting sutures)
  • Jones operation (plication of lower lid retractors)
  • Quickert procedure

Further reading

  • Involutional Entropion (2015) Available at: http://webeye.ophth.uiowa.edu/eyeforum/cases/220-involutional-entropion.htm (Accessed: 9 December 2016).

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