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A 50-year-old male presented with bilateral cicatricial entropion with subepithelial fibrosis and fornix foreshortening. Conjunctival biopsy showed lymphocytic infiltrate along the interface of the epithelium and lamina propria with linear, shaggy fibrinogen deposition along the epithelial basement membrane zone, supporting a diagnosis of lichen planus. The patient was treated with commercially available topical cyclosporine for 5 months after which bilateral lower eyelid splitting procedure with recession of the anterior lamella and complete excision of the lower eyelid lashes was performed.

Objective: To evaluate the efficacy of adhesive tape for temporary management of inturned upper eyelid eyelashes., Methods: In a prospective, consecutive, comparative, nonrandomized, interventional case series, 50 patients (100 eyes) had inturned eyelashes with at least 1 of 3 symptoms: foreign body sensation, itchiness, and tearing. Transpore tape was applied to the right upper eyelid of each patient; the left eye was used as a control. A questionnaire was used to assess relief or persistence of the symptoms before, during, and after tape adhesion., Results: Analysis of variance showed a significant difference between the study and control groups (P = .002). Tukey honestly significant difference analysis revealed a significant difference in symptoms before and during tape adhesion and a significant difference during and after tape adhesion. Symptoms in the control eye remained unchanged., Conclusion: Use of adhesive tape can be an effective temporary measure for relief of symptoms of inturned upper eyelid eyelashes.

Purpose: To evaluate the use of octyl-2-cyanoacrylate liquid bandage (Band-Aid liquid, Ethicon, Johnson & Johnson, New Jersey, USA) as a temporary treatment in patients awaiting surgical repair for involutional entropion., Methods: Thirteen patients (15 eyelids) with involutional entropion were evaluated while they waited for surgical intervention. The lids were repositioned by the application of octyl-2-cyanoacrylate liquid bandage in the malar fold. Patients were followed-up at days 1, 7 and 15. Assessment and duration of correction were recorded., Results: All the patients presented successful correction at day 1, with significant improvements in signs and symptoms. The mean duration of action of the octyl2-cyanoacrylate liquid bandage was three days. No ocular or dermatological reactions were noted., Conclusion: Octyl-2-cyanoacrylate liquid bandage showed to be a simple, safe and effective option to temporarily treat involutional entropion, while patients waited for surgical intervention.

Background: Many incisional techniques have been described for access to the craniofacial skeleton for traumatic fracture repair, including subciliary, subtarsal, and transconjunctival approaches. Each is associated with a distinct set of complications. The goal of the authors' study was to examine lower lid malposition associated with these incisional approaches at the authors' institution and in the literature., Methods: A retrospective chart review of all operative orbital and/or zygomatic fractures at the Beth Israel Deaconess Medical Center from 1998 to 2008 was performed. The surgical approach and postoperative lower eyelid complications were noted. A literature review was performed of all peer-reviewed studies in the English language examining the incidence of complications of lower eyelid incisions in operative facial trauma., Results: A total of 180 cases were treated with a lower eyelid incision; these were identified as subtarsal (41 percent), subciliary (31 percent), and transconjunctival (25 percent). The risk of ectropion was highest in subciliary incisions (12.5 percent, p = 0.018); however, only two cases required operative management. Entropion was found in two cases after transconjunctival incisions; both required operative management. Seventeen studies were included in the meta-analysis, representing 2086 patients. The risk of ectropion was highest in subciliary incisions (14 percent), the risk of entropion was highest in transconjunctival incisions (1.5 percent), and the risk of hypertrophic scarring was highest in subtarsal incisions (3.4 percent). A majority of these complications resolved with conservative management., Conclusions: Lower eyelid complications can be seen with all three incisional approaches to facial fracture repair. Based on their findings, the authors favor the subtarsal approach for zygomaticomaxillary fractures and the transconjunctival incision for isolated orbital floor fractures.

The authors report for the first time two cases of upper eyelid entropion secondary to neonatal conjunctivitis that resolved spontaneously following the insertion of a bandage contact lens. Previous reports advocate early surgical intervention to correct the eyelid abnormality and prevent any permanent corneal scarring and visual loss.

Aim: To examine the association between epilation and corneal opacity (CO) among trichiasis patients presenting for surgery., Methods: Cross sectional data from the STAR trial were utilised. Patients presenting for trichiasis surgery in Wolayta Zone, Ethiopia, were evaluated for current trichiasis status. Number of inturned lashes, evidence of epilation, level of entropion, trichiasis duration, and CO were collected. The primary outcome was prevalence of CO, stratified by entropion and epilation status., Results: Approximately 10% of eyes with mild entropion had CO, regardless of epilation status. Among eyes with moderate entropion, epilated eyes were less likely to have CO than non-epilated eyes (21% v 34% p = 0.002). The same association was seen in eyes with severe entropion: 43% of epilated eyes while 74% of non-epilated eyes had CO (p<0.0001). Presence of CO increased with age. Adjusted models showed a protective effect of epilation in eyes with moderate or severe entropion (OR: 0.51; 95% CI: 0.32 to 0.83 and OR: 0.24; 95% CI: 0.13 to 0.45, respectively). Among eyes with mild entropion there was no difference in the prevalence of CO comparing eyes that were epilated with those that were not epilated., Conclusion: Entropion was the most significant predictor of CO. Cross sectional associations suggest that epilation may not be helpful for eyes with mild entropion, but may offer protection against CO in eyes with moderate to severe entropion. Epilation should not be a substitute for trichiasis surgery, however, as 43% of eyes with severe entropion that were epilated still had CO.

Background: Entropion is a condition in which the eyelid margin turns in against the eyeball. The involutional or senile type of entropion is one of the most common lower lid malpositions in the elderly. The interventions described and currently used for the treatment of this condition are surgical in nature, although non-surgical temporary medical treatment for the early stages of entropion has also been reported. The relative effectiveness of these interventions has not yet been resolved., Objectives: The purpose of this review is to examine the effect of interventions for involutional entropion and to assess whether any method is superior to the others., Search Strategy: We searched the Cochrane Controlled Trials Register - CENTRAL/CCTR, which contains the Cochrane Eyes and Vision Group specialised register (Cochrane Library Issue 3, 2000), MEDLINE (1966 to October 2000), EMBASE (1980 to September 2000), the metaRegister of Controlled Trials (mRCT), oculoplastic textbooks, conference proceedings and bibliographies of relevant reports. We contacted investigators and experts in the field for details of other published and unpublished studies., Selection Criteria: The criteria for including studies in this review were randomised controlled trials where one intervention for involutional lower lid entropion has been compared to another method of treatment in people older than 60 years of age with involutional lower lid entropion., Data Collection and Analysis: Both reviewers assessed the search results according to the criteria for including studies in the review. No studies were found that met these criteria, and therefore no data were collected and no meta-analysis was performed., Main Results: Since no studies met our selection criteria no results were produced., Reviewer's Conclusions: No conclusions could be reached about the effectiveness of interventions for involutional lower lid entropion, although retrospective case series studies suggest that some forms of treatment may be associated with higher recurrence rates than others. Lack of suitable data highlights the need for randomised controlled trials in the fields of entropion management.

Purpose: To evaluate the efficacy of the use of tissue glue in temporary management of involutional entropion., Methods: Ten consecutive patients aged 68-74 years presenting senile entropion were included in the study. Lid repositioning as to achieve a slight ectropion was done by application of cyanoacrylate glue in the lower lid crease using a 20-G cannula. Patients were followed at 1 day, 7 days and finally at 14 days. Assessment of correction and, if absent, duration of correction was recorded. Any other ocular or dermatological complications of the application were also recorded., Results: All the patients had successful correction at day 1. In two patients adhesions broke at day 6, in one patient at day 7, in 3 at day 9 and 2 at day 11. Two patients maintained correction at 2 weeks. No ocular or dermatological reactions were noted., Conclusions: Tissue glue aided lid repositioning is an effective method for temporary management of involutional entropion.

Purpose: A prospective study was designed to evaluate the use of botulinum toxin as a temporary treatment in patients awaiting surgical repair for involutional entropion and to compare its use with lid taping., Methods: Botulinum toxin was administered to 30 patients with involutional entropion (35 eyelids). These patients had all previously been using lid taping and lubricant ointment as a temporary measure whilst awaiting lid surgery. Patients' symptoms and signs were assessed before and after toxin injection. The date of entropion recurrence was recorded. Eyelid tissue from 8 patients treated with toxin and 3 control patients who had not been given toxin was obtained after surgical entropion repair and examined histologically to ensure the botulinum toxin had no potential detrimental effects on the results of surgery., Results: The toxin was simple and quick to administer. Anatomical success was achieved in 33 of the 35 eyelids with significant improvements in symptoms and signs. The mean duration of action of the toxin was 12.5 weeks. Lower lid laxity was inversely correlated with duration of toxin action. There were no consistent changes in orbicularis oculi morphology after toxin injection., Conclusion: Botulinum toxin is a highly effective temporary treatment for involutional entropion with few complications and no adverse effects on the results of surgical entropion repair.

A simply designed entropion patch provided effective temporary preoperative relief of the symptoms of lid malposition in lower lid involutional entropion in six patients. The patch is easily fashioned and used after appropriate instruction, with its design taking into account lid mechanics and the pathophysiology of involutional entropion.

The Entropion in newborn lambs could be proved so far in 8 sheep-breeds and 7 cross-breeds out of 33 flocks in the Federal Republic of Germany. In our patients the Entropion was found at the lower eyelid only. The owners of the animals often mistake the Entropion for an ophthalmia. An early diagnosis and an early beginning of the therapy keep the expenditure of treatment small and shorten the period of treatment; therefore examination is commendable within a short time after birth. Female lambs get clearly more often affected than male ones (Gynecotropia). In small pure-bred flocks with only one breeding-ram (and also in breeds with a limited population) the percentage of suffering lambs is higher than in large and crossed flocks with several rams and in large populations (except the breed "Heidschnucke"). In agreement with the literature it must be supposed that different genes are responsible for the Entropion. The selection of ill animals and those which are suspected of transmitting the disposition is evidently appropriate to lower the number of attacks of illness within a population considerably. All 47 affected eyes of 32 lambs were treated. Low degrees of Entropion were healed by repeated manual eversion plus application of antibiotic eye-ointment. In middle and high degrees of Entropion the application of Michel-wound-clamps on 23 of 26 eyes was successful; antibiotic eye-ointment was applied here, too; additionally these lambs prophylactically got 2000 I.U. of Tetanus-antitoxin.(ABSTRACT TRUNCATED AT 250 WORDS)

Many surgical procedures have been described for correction of cicatricial entropion of the upper eyelid. However, many of them fail to address the altered anatomy responsible for cicatricial entropion, which may lead to excessive scarring, eyelid margin malposition, or blepharoptosis. Tarsoconjunctival grafts provide a strong and permanent buttress to correct the scarring of the posterior eyelid margin that characterizes cicatricial entropion. They provide a smooth mucosal surface to interface with the corneal tear film. Depending on the circumstances, we use free ipsilateral, free contralateral, or sliding "bucket handle" tarsoconjunctival grafting. Mucosal grafts are rarely needed. Blepharoptosis is avoided by conservative dissection in the supratarsal space, sparing most of the attachments of the levator aponeurosis.