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The entropion

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The entropion

  1. 1. TheEntropion Ashesh nagar
  2. 2. What it is??• “Inward rolling of the lid margin”
  3. 3. A disorder ofLid?? NOEyelid
  4. 4. Knowing a bit of eyelid willbe helpful • The tarsus • Muscles of lid • Glands • The margin • The tarsal conjuctiva
  5. 5. entropion trichiasis
  6. 6. What causes entropion???Disparity in length and tone between the• anterior skin-muscle or• posterior tarsoconjuctival lamina of eyelid
  7. 7. 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
  8. 8. 1. involutional 2. cicatririal classification 3.spastic 4.congenital
  9. 9. Involutional Dehisance of posterior lid retractors Laxity of canthal ligaments Vertical lid laxity Atrophy of orbital fat
  10. 10. Tx of involutionalCorrective measure procedureVertical skin-muscle shortening Zieglar cauteryHorizontal tightening of lid at lower bick proceduretarsal border Fox procedure Barricading of orbicularis fibers Weis procedure, Jone’s procedureTightning of orbicularis fibres Wheeler procedureReattachment of inferior retractors Jone’s procedure
  11. 11. 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.
  12. 12. 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.
  13. 13. Wedge resection
  14. 14. 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
  15. 15. Role of botox Post Pre-injection injection

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