Presentation
The condition is of gradual onset and often there is no history of previous inflammation, so whatever, irritation is present seems to be the result of the entropion and not the cause. [ijo.in]
If present, these can also cause secondary spastic entropion. Assess corneal status specifically for corneal abrasions, scarring, thinning, or neovascularization. [aao.org]
Entire Body System
- Surgical Procedure
• A new surgical procedure has been developed for the correction of senile entropion of the lower lid. [jamanetwork.com]
Surgery Temporizing surgical procedures Quickert-Rathbun rotational sutures Indications: For correction of lower eyelid involutional entropion when a more definitive procedure is not practical, such as if patient is a poor surgical candidate due to significant [aao.org]
- Collapse
Be sure to close tarsal plate with additional partial thickness horizontal 6‑0 vicryl sutures to reapproximate the full height of the tarsal plate to avoid collapse of the lid margin. [aao.org]
Eyes
- Enophthalmos
The technique is simple and effective when applied to chronic senile entropion unassociated with severe enophthalmos or any cicatricial component. [jamanetwork.com]
Decrease in orbital fat volume with age can increase enophthalmos and relative eyelid laxity, allowing for greater orbicularis override. [aao.org]
- Foreign Body Sensation
History Chronic foreign body sensation or irritation Pain Red eye Epiphora due to irritation or lash touch Discharge Decreased or blurry vision Clinical features Lower eyelid margin rotated inward against cornea (Figure 1) and conjunctiva causing corneal [aao.org]
- Photophobia
An acute form of this condition is seen in cases of ocular inflammation and after prolonged bandaging; it is found in young and old alike and is accompanied by blepharospasm, photophobia and lacrimation. [ijo.in]
- Corneal Infiltrate
Evaluate patient for ocular surface disease (i.e., surface keratopathy, corneal infiltrates) and etiology of entropion. Cicatrizing etiologies can demonstrate shortened fornices, symblepharon, and scarred posterior tarsal conjunctiva. [aao.org]
Psychiatrical
- Suggestibility
Treatment Many procedures have been suggested for the correction of senile entropion. The great list of the remedies indicates that none of them is fully effective. [ijo.in]
Deeper inferior fornix or more prominent subconjunctival fat on the affected side would suggest dehiscence of the inferior retractors because the retractors also have fibers that insert into the inferior fornix in addition to the insertions into the inferior [aao.org]
- Distractibility
Eyelid taping: Secure a 3‑cm tape strip about 0.5 cm below the central lower eyelid and gently distract in a lateral and slightly elevated position to evert the margin to normal position (Stevens, Comm Eye Health 2012). [aao.org]
Neurologic
- Irritability
The condition is of gradual onset and often there is no history of previous inflammation, so whatever, irritation is present seems to be the result of the entropion and not the cause. [ijo.in]
History Chronic foreign body sensation or irritation Pain Red eye Epiphora due to irritation or lash touch Discharge Decreased or blurry vision Clinical features Lower eyelid margin rotated inward against cornea (Figure 1) and conjunctiva causing corneal [aao.org]
Treatment
Preventing and managing treatment complications Recurrence can happen, although less commonly than with Quickert sutures. [aao.org]
PMID: 523074 [Surgical treatment of senile entropion and ectropion of the lower lid (author's transl)]. Piffaretti JM. Piffaretti JM. Klin Monbl Augenheilkd. 1981 Apr;178(4):241-3. doi: 10.1055/s-2008-1057194. Klin Monbl Augenheilkd. 1981. [pubmed.ncbi.nlm.nih.gov]
A small tender swelling developed at the site of the incision (a stitch abscess), but it subsided readily with medical treatment. [ijo.in]
Etiology
Evaluate patient for ocular surface disease (i.e., surface keratopathy, corneal infiltrates) and etiology of entropion. Cicatrizing etiologies can demonstrate shortened fornices, symblepharon, and scarred posterior tarsal conjunctiva. [aao.org]
Epidemiology
Epidemiology Occurs in up to 2.1% of the elderly population (1.9% men and 2.4% women), with significant tissue laxity (Damasceno, Ophthal Plast Reconstr Surg 2011). [aao.org]
Prevention
Close orbicularis muscle and skin edges in layered fashion (scar prevents overriding orbicularis). Preventing and managing treatment complications Recurrence can happen, although less commonly than with Quickert sutures. [aao.org]