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Congenital Entropion

Isolated Congenital Entropion


Presentation

  • To describe a case of congenital entropion presenting with ulcerative keratitis that was successfully treated with a single injection of botulinum toxin. Interventional case report.[ncbi.nlm.nih.gov]
  • […] if the condition was present at the time of inpatient admission.[icd.codes]
  • AB - Purpose To describe a case of congenital entropion presenting with ulcerative keratitis that was successfully treated with a single injection of botulinum toxin. Design Interventional case report.[mayoclinic.pure.elsevier.com]
Fishing
  • Surgical method: On the epicanthus, a small, triangular “fish-tail” flap that was 2 mm wide was designed and was located adjacent to a “fish-body” marking on the subciliary lower eyelid.[dovepress.com]
  • Surgical Method: On the epiblepharon, about 2mm-wide small triangle shape fish-tail flap was designed continuously fish-body marking on subciliary lower eyelid. After incision, Hotz procedure was done and skin flap was sutured edge to edge.[omicsonline.org]
Weight Gain
  • The pregnancy was complicated by a greater than 20 lb. weight gain, which was treated with diuretics. The mother was hospitalized in the third month because of a brown vaginal discharge which ceased spontaneously with bedrest.[healio.com]
Multiple Congenital Anomalies
  • The classification of PCUEE as a syndrome with multiple congenital anomalies is supported, and the need for a complete systemic evaluation is stressed. Congenital primary upper eyelid entropion is an exceedingly rare condition.[healio.com]
Failure to Thrive
  • .), aged three and one-half months, was admitted to Children's Hospital of Pittsburgh, because of a failure to thrive. This was the fourth pregnancy, separated by nine years from the third, for a white female, aged 39.[healio.com]
Ejection Murmur
  • There was a grade 3/6 systolic ejection murmur at the mid to lower left sternal border. An electrocardiogram showed evidence of severe left axis deviation and right ventricular hypertrophy.[healio.com]
Cardiomegaly
  • Cardiac evaluation revealed a mild ventriculo-septal defect and cardiomegaly.[healio.com]
Low Set Ears
  • Neonatal exam revealed a dysmorphic facies with antimongoloid slanting of the palpebral fissures, low-set ears which appeared dysplastie with underdeveloped pinnae, micrognathia, and long thin feet with rocker bottoms.[healio.com]
Flexion Contracture
  • Orthopedic consultation revealed bilateral mild knee flexion contractures and bilateral calcaneal valgus feet. Repeat CT scan indicated evidence of cerebral atrophy, and EEG showed progressive deterioration.[healio.com]
Antimongoloid Slant
  • Neonatal exam revealed a dysmorphic facies with antimongoloid slanting of the palpebral fissures, low-set ears which appeared dysplastie with underdeveloped pinnae, micrognathia, and long thin feet with rocker bottoms.[healio.com]
Hyperpigmentation
  • A. and HORWICH, H.: Congenital Entropion and Tetratrichiasis of Upper Lids, Palpebral Hyperpigmentation, ana Mental Deficiency. Arch. Ophth., 52:865-870, December 1954. 14. KARLIN, D.[healio.com]
Vaginal Discharge
  • The mother was hospitalized in the third month because of a brown vaginal discharge which ceased spontaneously with bedrest. Following a three hour labor, under general anesthesia, a 7 lb. 4 oz. boy was delivered by cephalic presentation.[healio.com]
Hyperactivity
  • The physical examination revealed an irritable, tense, crying infant who was hyperactive to noise and movements. He neither smiled, cooed, nor had a good sustained sucking reflex.[healio.com]
Tonic-Clonic Seizure
  • The patient demonstrated developmental delay, and at age eight months developed focal tonic-clonic seizures, controlled with Phénobarbital.[healio.com]

Workup

  • Methods: : Patients with congenital eyelid anomalies presented during one year period (Dec 2006 - Nov 2007) with complete clinical workup were included. Karyotyping from blood was done in all the patients.[iovs.arvojournals.org]
Left Axis Deviation
  • An electrocardiogram showed evidence of severe left axis deviation and right ventricular hypertrophy. These findings led to a diagnosis of endocardial cushion defect with pulmonary hypertension.[healio.com]
Ventricular Hypertrophy
  • An electrocardiogram showed evidence of severe left axis deviation and right ventricular hypertrophy. These findings led to a diagnosis of endocardial cushion defect with pulmonary hypertension.[healio.com]

Treatment

  • Christiansen, G, Mohney, BG, Baratz, K & Bradley, EA 2004, ' Botulinum toxin for the treatment of congenital entropion ', American Journal of Ophthalmology, vol. 138, no. 1, pp. 153-155.[mayoclinic.pure.elsevier.com]
  • Four days after treatment, the entropion had resolved and the corneal epithelial defect had healed. There was no recurrence of the entropion 7 months after botulinum toxin injection.[ncbi.nlm.nih.gov]
  • The treatment of epiblepharon depends on the presence of corneal damage caused by lashes scratching the cornea. The treatment of congenital entropion is surgical. Surgery can be delayed as long as the corneal findings are not severe.[neweyelids.com]

Prognosis

  • Expectations (prognosis) The outlook is usually good if the condition is treated before cornea damage occurs.[pittsburgheyeassociates.com]
  • Prognosis : good. Presenting signs Epiphora Eye: epiphora . Mucopurulent ocular discharge Eye: ocular discharge - overview when concurrent ocular infection is present. Periocular crusting associated with ocular discharge. Periocular irritation.[vetstream.com]
  • If inflammation or infection are not controlled, the prognosis is worse, higher risk of complications, and can often progress.[statpearls.com]

Etiology

  • This finding refutes the commonly accepted concept of orbicularis muscle hypertrophy as an etiologic mechanism of congenital entropion.[ncbi.nlm.nih.gov]

Pathophysiology

  • The simple surgical procedure described would probably be successful in most cases, assuming that pathophysiologic mechanism is correct. References 1. Hiles DA, Wilder LW: Congenital entropion of the upper lids.[healio.com]
  • The pathophysiology is related to a loss of supportive structures in the lower lid. With age, the medial and lateral canthal tendons develop some laxity. The lower eyelid retractors also become thin and attenuated.[csops.com]
  • Recurrences that present a year or more after surgery may be due to progression of underlying pathophysiology.[medtextfree.wordpress.com]
  • Entropion • Involutional (senile) • Pathophysiology – Upward migration of preseptal orbicularis over the posterior lamellae – Laxity or dehiscence of eyelid retractors – Horizontal lid laxity 16.[slideshare.net]
  • […] additional skin (flap or graft), release any vertical scar bands, horizontally tighten eyelid Paralytic Horizontally tighten eyelid, possibly reinforced by periosteal flap or fascial sling; palpebral spring Entropion Congenital Depends upon specific pathophysiologic[reviewofophthalmology.com]

Prevention

  • - 0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis[medicbind.com]
  • If encountered, these should be excised and repaired. [1] The surgeon should be cognizant of the marginal arcade during entropion repair to prevent necrosis at the lid margin.[eyewiki.aao.org]
  • Centers for Disease Control and Prevention Intersex (Medical Encyclopedia) [ Read More ] Eyelid Disorders Your eyelids help protect your eyes. When you blink, your eyelids spread moisture over your eyes.[icdlist.com]
  • Most cases are not preventable.[pittsburgheyeassociates.com]
  • Prevention Generally, entropion isn't preventable. You may be able to prevent the type caused by trachoma infection.[mayoclinic.org]

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