Entropion
Entropion is
an inward turning of the lower lid margin against the eyeball.
Patients complain of the lashes rubbing against the eye, which
can cause damage to the cornea by ulceration and infection. The
basic causes are:
-
AGE: The
eyelid is held in goad position by two sets of muscles. One
pulls the eyelid away from the eyeball, while the other turns
the lid toward the eyeball. When an imbalance in this system
favors the set pulling toward the eye, an entropion results.
This imbalance is a natural consequence of te aging process.
-
SCARRING:
This may result from many different diseases or injuries again
causing the characteristic imbalance in the muscles
controlling the lower lid.
-
CONGENITAL: An entropion from birth is very rare.
-
SPASTICITY:
Here the eyes are vigorously closed because of inflammation,
eye surgery or injury. The lower lid may turn on itself due
to this strenuous attempt at closure.
Treatment is
surgical in most cases – except for the temporary spastic
entropion, which will clear up when the Inciting agent is
removed.
The purpose
of surgery is to strengthen the muscles that draw the lid away
from the eye. Sometimes a better approach is to tighten up the
whole lid to put it in better position. Each patient is
different, and many factors are taken into consideration in
planning the correct surgical procedure.
Entropion
repair is done with a local anesthetic as an outpatient, no
hospitalization and is well tolerated. Potential problems with
this surgery include:
-
Over
correction with consequent eversion of the lower lid (this
usually corrects itself within a few weeks)
-
Infection
Recuurence
(recurrence rates have improved dramactically with better
understanding of the abnormal muscles involved and better
surgical techniques.
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