Entropion is the turning in of an edge of an eyelid, causing the lashes to rub against the eye. It usually is seen on the lower eyelid.
- Aging creating loose skin and stretched and loose ligaments and muscles.
- An eye infection called trachoma is still common in North Africa and South Asia and this can cause scarring of the inner eyelid, which may cause friction and entropion.
- Decreased vision if the cornea is damaged
- Excessive tearing
- Eye discomfort or pain
- Eye irritation
Artificial tears can keep the eye from becoming dry and may help you feel better.
Simple surgery in which excess skin of the outer lids is removed or tendons and muscles are shortened with one or two stitches. General anesthesia is sometimes used before local anesthetics are injected into the muscles around the eye. Prognosis is excellent if surgery is performed before the cornea is damaged.
Atlas of Entropion:
Lower Lid Entropion Correction (Wies Procedure)
The principle of Weis procedure is to split the lower lid transversely to create a fibrous tissue scar barrier which prevents the upward movement of the pre-septal muscle. This is combined with everting sutures which shorten the lower lid retractors and transfer their pull to the upper border of the tarsus.
This procedure gives a long term cure of an entropion with little horizontal lid laxity.
Upper eyelid entropion Correction Posterior lamellae advancement Procedure
Tarsal margin rotation with posterior lamella superadvancement appears to be effective in managing cicatricial entropion of the upper lid.
Tarsal margin rotation with extended posterior lamellae advancement appears to be effective with no recurrence in managing cicatricial entropion and accompanying multiple eyelash problems of the upper eyelid due to trachoma.
Entropion surgery for upper lid using Fugo blade
The lid is everted with a a stout Desmar lid retractor. An incision is made on the Arlt line with 100 micron Fugo blade tip. The incision is deepened gradually, at the same time maintaining the pressure of the retractor. This reduces bleeding and spreads tarsal plate. Once the tarsal plate has been cut throughout the length, 600 micron Fugo blade is used to undermine both sides of the incision. It also stops any bleeding point. A 5 zero absorbable suture is applied from the right to the left side (for right handers). The needle traverses the space under the split tarsal plate on both sides. A key pattern suture is applied. As it is pulled the lid margin turns outwards. After fastening the suture on the left end, the suture is passed subcutaneously to reach the starting point on the right side, where it is tied to the tail end.
Entropion Diagnosis and Treatment Notes