This presentation deals with ectropion and entropion, their causes, types and management

1. ECTROPION & ENTROPION
KABILAN. S

2. OBJECTIVES
• Entropion and its types
• Treatment for entropion
• Ectropion and its types
• Treatment for ectropion

3. ANATOMY

4. Lid retractors

5. ENTROPION
Inward rolling and rotation of lid margin toward the globe

6. Types
• Congenital (Horizontal tarsal kink syndrome)
- lower lid
- upper lid
• Cicatricial
- commonly in upper lid
- trachoma, trauma, chemical injuries

7. • Senile (Involutional entropion)
- horizontal lid laxity
- vertical lid instability
- overriding of pretarsal by preseptal orbicularis
- orbital septum laxity – prolapse of orbital fat into lower lid
• Mechanical
- lack of support provided by globe to lids
- phthisis bulbi

8. Clinical features
PRESENTATION :
• Foreign body sensation
• Irritation
• Lacrimation
• photophobia

9. Signs
• Inturning of lid margins
- grade 1
- grade 2
- grade 3
• Signs of causative factors
• Signs of complications
- corneal abrasions, opacities, ulcers

10. TREATMENT
• Congenital entropion
- Hotz procedure

11. CICATRICIAL ENTROPION
• Anterior lamellar resection
• Tarsal wedge resection
(Snellen’s operation)
• Transposition of tarsoconjunctival wedge (Modified Ketssey’s operation)
• Composite grafts

13. SENILE ENTROPION
• Transverse everting sutures
• Wies operation
• Jones operation
• Quickert procedure

15. ECTROPION
Outrolling or outward turning of the lid margin

16. TYPES
• Congenital
- Down’s syndrome
• Involutional
- horizontal laxity
- disinsertion of lower lid retractors
- medial/lateral canthal tendon laxity
• Paralytic
- paralysis of facial nerve
- Bell’s palsy, middle ear infections, parotidectomy

17. • Mechanical
- tumor, proptosis
• Cicatricial
- burns, lacerations, ulcers

18. CLINICAL FEATURES
PRESENTATION
• Irritaion
• Discomfort
• Photophobia
• Epiphora

19. Signs
• Outrolled lid margin
- grade 1
- grade 2
- grade 3
• Signs of causative factors
- scars
- 7th nerve palsy

20. INVOLUTIONAL ECTROPION
• Positive snap test
• Medial canthal tendon laxity
• Lateral canthal tendon laxity

21. Complications
• Exposure keratitis
• Dryness and thickening of conjunctiva
• Eczema and dermatitis of lower lid

22. TREATMENT
• Congenital ectropion
- full thickness skin graft
• Involutional ectropion
- medial conjunctivoplasty
- horizontal lid shortening
- Bryon smith’s modified kuhnt
Szymanowsky operation

24. • Paralytic ectropion
- temporary methods (topical lubricant, taping eyelids, temporal
tarsorrhaphy)
- Permanent methods :
- medial canthoplasty
- gold weight implantation
- palpebral sling operation

25. • Cicatricial ectropion
- V-Y plasty, Z plasty
- excision of scar tissue and full thickness skin graft

26. SUMMARY
• ENTROPION – TYPES – SURGERY
• ECTROPION – TYPES – SURGERY

27. THANKOOOO