Entropion-Ectropion

Abstract

Involutional eyelid malposition directly correlates with axial globe length with the ectropion group having lengthier eyes compared with the entropion group. Hence, axial globe length could be an influential factor in the onset of involutional eyelid malposition.

Using A modified quickert procedure combined with prolapsed fat and preseptal orbicularis muscle removal to correct involutional lower eyelid entropion in Asians

“…Previous studies have revealed no obvious differences between Asians and Caucasians from the perspective of causative factors, including the medial and lateral canthal laxity, lower eyelid retractors dehiscence [ 12 , 19 ] or a pretarsal OOM overriding [ [20] , [21] , [22] ]. Differences in the prevalence of involutional entropion may be attributed to other factors, such as fat projection in the lower eyelid [ 9 , 11 , 12 ], and smaller axial globe projection [ [6] , [7] , [8] , [9] ], which are more prevalent in Asians [ 2 , 14 ].…”

“…The main causative factors in the development of involutional lower eyelid entropion include the classic triad: horizontal eyelid laxity from loosening tarsus and canthal structures; vertical eyelid laxity with dehiscence of the retractor; and overriding of the preseptal orbicularis oculi muscle (OOM) onto the pretarsal OOM [ [3] , [4] , [5] ]. In addition, other contributory factors of lesser effect have been described, including age-related orbital fat atrophy causing relative enophthalmos and smaller axial ocular globe projection [ [6] , [7] , [8] , [9] ], degenerative change of the tarsal plate [ 4 , 10 ], and orbital fat prolapse [ 9 , 11 , 12 ].…”

“…In elderly Asian individuals, the three classic triad factors are widely accepted as the main causes of lower eyelid involutional entropion. However, fat projection in the lower eyelid and smaller axial globe projection often occur in Asian patients [ 1 , 7 , 8 ]. The higher incidence of involutional lower eyelid entropion is noticed in East Asians than non-East-Asians [ 2 , 13 , 14 ].…”

Conjunctivochalasis

“…26,27 It is thought that eyes with a shorter axial length (<20 mm) have an increased risk of developing CCh, possibly due to the reduced conjunctival tension, which may result in the formation of LIPCOFs. Furthermore, hyperopia may be a risk factor for involutional entropion 28,29 which can increase friction on the conjunctiva when patients are looking downwards and subsequently exacerbate CCh.…”