eMedicine Specialties > Ophthalmology > Lid

Entropion: Differential Diagnoses & Workup

Author: Christopher DeBacker, MD, Volunteer Faculty, Department of Ophthalmology, California Pacific Medical Center; Consulting Staff, Ophthalmic Medical Associates
Coauthor(s): Robert M Dryden, MD, FACS, Clinical Professor, Department of Ophthalmology, University of Arizona School of Medicine
Contributor Information and Disclosures

Updated: Oct 30, 2009

Differential Diagnoses

Distichiasis
Trachoma
Trichiasis

Other Problems to Be Considered

Epiblepharon
Eyelid retraction

Workup

Laboratory Studies

  • Very few laboratory ancillary studies are required in the workup of entropion.
  • For patients with a cicatricial entropion picture in whom ocular cicatricial pemphigoid is suspected, an autoimmune process should be ruled out by testing for antibasement membrane antibodies on a section of conjunctiva obtained during a biopsy.
  • For patients with involutional entropion it is helpful to document exophthalmometry readings to determine if relative enophthalmos is present.
  • It is wise to examine the mouth of patients with cicatricial entropion, for the purpose of detecting oral mucus membrane lesions and also to verify the presence of adequate mucus membrane or hard palate if grafting procedures are required.

More on Entropion

Overview: Entropion
Differential Diagnoses & Workup: Entropion
Treatment & Medication: Entropion
Follow-up: Entropion
Multimedia: Entropion
References
Further Reading
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References

  1. Awan MA, Chadha V, Gonzalez P, Diaper CJ, Cauchi P, Kemp EG. Small tarsal plates causing recurrent lower lid entropion in a young adult. Eye. Feb 6 2009;[Medline].

  2. Pasco NY, Kikkawa DO, Korn BS, Punja KG, Jones MC. Facial nerve paralysis: an unrecognized cause of lower eyelid entropion in the pediatric population. Ophthal Plast Reconstr Surg. Mar-Apr 2007;23(2):126-9. [Medline].

  3. Maycock NJ, Sahu DN, Mota PM, Gaston H, Hodgkins PR. Conservative management of upper eyelid entropion. J Pediatr Ophthalmol Strabismus. Nov-Dec 2008;45(6):377-8. [Medline].

  4. Gu J, Wang Z, Sun M, Yuan J, Chen J. Posterior lamellar eyelid reconstruction with acellular dermis allograft in severe cicatricial entropion. Ann Plast Surg. Mar 2009;62(3):268-74. [Medline].

  5. Swamy BN, Benger R, Taylor S. Cicatricial entropion repair with hard palate mucous membrane graft: surgical technique and outcomes. Clin Experiment Ophthalmol. May 2008;36(4):348-52. [Medline].

  6. Hintschich C. Correction of entropion and ectropion. Dev Ophthalmol. 2008;41:85-102. [Medline].

  7. Ho SF, Pherwani A, Elsherbiny SM, Reuser T. Lateral tarsal strip and quickert sutures for lower eyelid entropion. Ophthal Plast Reconstr Surg. Sep 2005;21(5):345-8. [Medline].

  8. Bartley GB, Kay PP. Posterior lamellar eyelid reconstruction with a hard palate mucosal graft. Am J Ophthalmol. Jun 15 1989;107(6):609-12. [Medline].

  9. Cheung D, Sandramouli S. Consecutive ectropion after the Wies procedure. Ophthal Plast Reconstr Surg. Jan 2004;20(1):64-8. [Medline].

  10. Christiansen G, Mohney BG, Baratz KH, Bradley EA. Botulinum toxin for the treatment of congenital entropion. Am J Ophthalmol. Jul 2004;138(1):153-5. [Medline].

  11. Dortzbach RK, McGetrick JJ. Involutional entropion of the lower eyelid. Ophthalmic Plast Reconstr Surg. 1983;2:257-267.

  12. Khan SJ, Meyer DR. Transconjunctival lower eyelid involutional entropion repair: long-term follow-up and efficacy. Ophthalmology. Nov 2002;109(11):2112-7. [Medline].

  13. McCord CD Jr, Chen WP. Tarsal polishing and mucous membrane grafting for cicatricial entropion, trichiasis and epidermalization. Ophthalmic Surg. Dec 1983;14(12):1021-5. [Medline].

  14. Millman AL, Katzen LB, Putterman AM. Cicatricial entropion: an analysis of its treatment with transverse blepharotomy and marginal rotation. Ophthalmic Surg. Aug 1989;20(8):575-9. [Medline].

  15. Quickert MH, Rathbun E. Suture repair of entropion. Arch Ophthalmol. Mar 1971;85(3):304-5. [Medline].

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Keywords

entropion, involutional entropion, cicatricial entropion, acute spastic entropion, congenital entropion, eyelid entropion, eyelid inversion, eyelid margin inversion, ocular irritation, eyelid retraction, corneal abrasions

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Contributor Information and Disclosures

Author

Christopher DeBacker, MD, Volunteer Faculty, Department of Ophthalmology, California Pacific Medical Center; Consulting Staff, Ophthalmic Medical Associates
Christopher DeBacker, MD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Coauthor(s)

Robert M Dryden, MD, FACS, Clinical Professor, Department of Ophthalmology, University of Arizona School of Medicine
Robert M Dryden, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Cosmetic Surgery, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Ophthalmology, American College of Surgeons, American Society of Ophthalmic Plastic and Reconstructive Surgery, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Ron W Pelton, MD, PhD, Private Practice, Colorado Springs, Colorado
Ron W Pelton, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Colorado Medical Society, Utah Medical Association, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Mark T Duffy, MD, PhD, Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic
Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience
Disclosure: Allergan - Botox Cosmetic Consulting fee Consulting; Quest medical - lacrimal balloons Honoraria Speaking and teaching; Ortho-Neutrogenia Consulting fee Consulting

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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