In contrast to epiblepharon, eyelid margin inversion is present in congenital entropion. Developmental factors that lead to this rare condition include lower eyelid retractor dysgenesis, structural defects in the tarsal plate, and relative shortening of the posterior lamella. Unlike epiblepharon, congenital entropion is unlikely to improve spontaneously and may require surgical correction. Congenital entropion may be repaired by removing a small amount of the skin and orbicularis muscle along the subciliary portion of the eyelid, advancing the lower eyelid retractors to the tarsus, and lengthening the posterior lamella.
Tarsal kink (Fig 10-10) is an unusual form of congenital entropion in which the upper eyelid tarsal plate is folded, resulting in entropion. It may be repaired by removal of the kink in combination with a margin rotation. In some cases, skin grafting for the anterior lamella may be necessary.
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.