2020–2021 BCSC Basic and Clinical Science Course™
7 Oculofacial Plastic and Orbital Surgery
Part II: Periocular Soft Tissues
Chapter 12: Periocular Malpositions and Involutional Changes
Acute Spastic Entropion
Acute spastic entropion arises from ocular irritation or inflammation. Sustained contraction of the orbicularis oculi muscle leads to inward rotation of the eyelid margin. A cycle of increasing frequency of orbicularis muscle spasm caused by corneal irritation perpetuates the problem. The acute entropion usually resolves when the cycle is broken by treatment of the underlying cause.
Taping of the entropic eyelid to evert the margin, cautery, or various rotational suture techniques (see Fig 12-5) afford temporary relief for most patients. In selected cases, botulinum toxin injection can be used to temporarily paralyze the overriding preseptal orbicularis muscle. However, involutional changes are often present in the eyelid; therefore, definitive surgical repair may be required.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.