Ectropion & entropion

Question 1

What is the definition of ectropion?

Answer 1

abnormal eversion of eyelid (away from globe)

Question 2

what is the symptoms of ectropion?

Answer 2

Dry eyes and irritation

Epiphora (excessive lacrimation)

(1) punctum is turned out, out of contact with tear lake 🡪 cannot drain tears
(2) reflex tearing 2’ to irritation

FB sensation

Question 3

what is the signs of ectropion?

Answer 3

• Loss of lid-globe apposition w/ inferior scleral show

- Conjunctival injection

Question 4

what are the investigations of ectropion?

Answer 4

fluorescein staining to check for epithelial defects 2’ exposure keratopathy

Question 5

what are the causes of ectropion?

Answer 5

• Age related (most common)
• Cicatricial - scarring on lower eyelid skin causing outward traction, 2’ to prev Sx (e.g. xanthelasma excision)/chemical injury
• Mechanical (e.g. masses pulling lower eyelid down)
• Paralytic (e.g. CN7 palsy/facial nerve palsy – weak orbicularis oculi)
• Congenital (imbalance in eyelid muscle tone)

Question 6

what is the definition of entropion?

Answer 6

abnormal inversion of eyelid (towards globe), may be a/w inward rolling of lower eyelashes)

Question 7

what are the symptoms of entropion?

Answer 7

• Epiphora (excessive lacrimation)

- FB sensation

Question 8

what are the signs of entropion?

Answer 8

Superficial punctate keratitis (2’ corneal abrasions) -> secondary keratitis (potentially sight threatening)

Question 9

what are the causes of entropion?

Answer 9

• Age related
• Cicatricial (e.g. conjunctiva/fornix scarring secondary to SJS, acid injury)
• Congenital
• Blepharospasm (focal muscle dystonia)

Question 10

what is the management of entropion?

Answer 10

• Lubricants, ointments
• Definitive Sx: horizontal tightening of lower lid w reattachment of lower lid retractors
• Note: entropion is risk factor for endophthalmitis 🡪 must repair entropion before any eye surgery