Other Tests
See the list below:
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Snap-back test
Perform this test by pulling the lower lid away and down from the globe for several seconds. If the lid resumes position, note the time required for the lid to return to its original position without the patient blinking.
The snap-back test provides a good idea of relative lower lid laxity. Lids with normal laxity immediately spring back to original position; the longer this takes, the more laxity is present.
Assign grades on a scale from 0-4 (0 = normal laxity, 4 = severe laxity).
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Medial canthal laxity test
Perform this test by pulling the lower lid laterally from the medial canthus. Measure displacement of the medial punctum. Greater distance equates to more laxity. Normal displacement ranges from only 0-1 mm.
Assign grades on a scale from 0-4 (0 = normal laxity, 4 = severe laxity).
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Lateral canthal laxity test
Perform this test by pulling the lower lid medially from the lateral canthus. Measure displacement of the lateral canthal corner. Greater distance equates to more laxity. Normal displacement ranges from only 0-2 mm.
Assign grades on a scale from 0-4 (0 = normal laxity, 4 = severe laxity).
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Schirmer test
Because entropion is only one of several differential diagnoses of epiphora, having a measure of the degree of eye dryness is important. The Schirmer test is used to assess tear production and provides such a measure. [4]
Tiny filter paper tabs are inserted in the lower lids and removed after a few minutes. The dampened area is measured in millimeters.
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Fluorescein cornea test
This test is essential when looking for signs of corneal damage.
It can detect damage from lashes or lid skin rubbing on the cornea.
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Lacrimal system irrigation
Check for lacrimal system blockage.
If the system is blocked, a dacryocystorhinostomy (alone or in combination with an entropion procedure) would possibly be better than treating the entropion alone.
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Slit-lamp examination
This examination is especially good for checking corneal status.
The test also checks for evidence of dryness.
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Presence or absence of Bell phenomenon test
Instruct patient to attempt eye closure while the examiner holds lids open.
If eyes move up, the test indicates a positive result for Bell phenomenon.
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Orbicularis muscular tone check
Check orbicularis muscular tone if the patient exhibits evidence of ocular muscle spasm caused by postoperative irritation, essential blepharospasm, or hemifacial spasm.
Ask the patient to squeeze eyes shut. Note how much worse the entropion is immediately after opening.
Grade the strength from 0-4 (0 = no paralysis, 1 = weak, 2 = normal, 3 = overactive, 4 = spastic).
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Lower eyelid anatomy.
