How to Diagnose Entropion

Entropion is an inward folding of the eyelid such that the lashes rub against the surface of the cornea. It rarely causes problems in infants because their lashes are so soft, but entropion can be more serious in older patients.

Instructions

• 1

  Classify the enropion by determining its etiology.

• 2

  Identify congenital entropion. An abnormal development of the lower eyelid retractors or a paucity of tissue that creates instability in the eyelid is usually the cause. Congenital entropion of the upper eyelid most commonly results from structural defects in the tarsal plate.

• 3

  Recognize acute spastic entropion. An inward turning of the eyelid margin can occur when eyelid spasms cause the orbicularis oculi muscle to overwhelm the lower eyelid retractors. These patients usually develop an involutional component as well.

• 4

  Diagnose involution entropion with the snap test. Pull back the eyelid and release it. A poor snap back can indicate the medial or lateral canthal tendons are suffering from a horizontal laxity. An involution of the posterior eyelid retractors is the most common type, but involution of soft tissue in the orbits also can lead to involution entropion.

• 5

  Examine the patient for signs of cicatricial entropion. Scarring of the conjunctiva usually will present because of chemical burns or some other trauma. It will be difficult to evert the eyelid in cases of cicatricial entropion, but this procedure should be easy if the patient has involutional entropion. Examining the tarsus and palpebral conjunctiva will usually confirm a diagnosis of cicatricial entropion.