TheEntropion

Ashesh nagar

What it is??

• “Inward rolling of the lid margin”

A disorder of

Lid??

EyelidNO

Knowing a bit of eyelid will be helpful

• The tarsus• Muscles of lid• Glands• The margin• The tarsal conjuctiva

entropion trichiasis

What causes entropion???

Disparity in length and tone between the

• anterior skin-muscle

or• posterior tarsoconjuctival lamina

of eyelid

It menifests as…• Redness and pain around the eye• Sensitivity to light and wind• Sagging skin around the eye• Excessive tears• Decreased vision, especially if the cornea is damaged

1. involutional3.spastic

classification

InvolutionalDehisance of

posterior lid retractorsLaxity of canthal

ligamentsVertical lid laxityAtrophy of orbital fat

Tx of involutional

Corrective measure procedure

Vertical skin-muscle shortening Zieglar cautery

Horizontal tightening of lid at lower tarsal border

bick procedureFox procedure

Barricading of orbicularis fibers Weis procedure,Jone’s procedure

Tightning of orbicularis fibres Wheeler procedure

Reattachment of inferior retractors Jone’s procedure

Cicatricial

• cicatrization of palpebral conjunctiva.

(trauma, chemical burns, Stevens-Johnson syndrome, ocular cicatricial pemphigoid (OCP), infections, or local response to topical medication)

• Examination of the tarsus and palpebral conjunctiva usually will point to the diagnosis in these cases.

Treatment of cicatritial entropion

• Depending on the degree of scarring and entropion, the etiology of the cicatricial changes, and the status of the tarsal plate.

• Wedge resection• Tarsal fracture• Wies procedure• More extensive scarring may require oral mucous

membrane (eg, buccal mucosa) or cadaveric dermis (eg, Alloderm) grafts.

Wedge resection

Spastic entropion

ocular irritation in the form of inflammation trauma Recent surgery Tight bandaging or due to degeneration of palpebral connective tissue separating the fibers of

orbicularis muscle Age related degeneration of tarsal muscle

Role of botox

Pre-injection

Post injection