spastic entropion

Spastic entropion is a type of entropion characterized by an inward turning of the eyelid margin, often caused by acute ocular irritation or inflammation [10]. This condition can occur in response to various factors such as infection, inflammation, and eye irritation [11]. It is commonly seen in patients with underlying involutional eyelid changes, particularly after undergoing eye surgery [12].

The symptoms of spastic entropion include an inward rolling-in of the lower lid, with the lashes rubbing against the cornea, leading to eye irritation and redness [7][13]. This condition can be intermittent, making it easy to miss a diagnosis. To make the entropion evident, asking the patient to squeeze their lids together forcefully or instilling eye drops into the conjunctival sac may bring out the condition [3].

Spastic entropion is often associated with involutional changes in the eyelid, which can lead to an overactive and hypertrophic preseptal orbicularis muscle [14]. This can cause the eyelid itself to become edematous, adding to the abnormal mechanical forces that turn the margin and lashes inward.

In summary, spastic entropion is a type of entropion characterized by an inward turning of the eyelid margin, often caused by acute ocular irritation or inflammation. It is commonly seen in patients with underlying involutional eyelid changes and can be intermittent, making it easy to miss a diagnosis.

Spastic entropion is a condition characterized by inward rotation of the eyelid margin, which can cause various signs and symptoms. Here are some of the common ones:

• Foreign body sensation: Many people with spastic entropion experience a feeling like there's something in their eye, even when nothing is present [1].
• Redness and irritation: The inward rotation of the eyelid margin can cause friction against the surface of the eye, leading to redness, irritation, and sometimes pain [2][3].
• Tearing and discharge: Excessive tearing and discharge are common symptoms of spastic entropion, as the eyelashes and outer eyelid rub against the surface of the eye [4][5].
• Sensitivity to light and wind: People with spastic entropion may experience sensitivity to light and wind, which can exacerbate the discomfort [6].
• Blurry vision: In some cases, spastic entropion can cause blurry vision due to the inward rotation of the eyelid margin and the resulting friction against the surface of the eye [7][8].

These symptoms can vary in severity and may be accompanied by other signs such as skin irritation or infection. If you're experiencing any of these symptoms, it's essential to consult with an eye care professional for proper diagnosis and treatment.

References: [1] Context result 5 [2] Context result 4 [3] Context result 6 [4] Context result 10 [5] Context result 13 [6] Context result 7 [7] Context result 11 [8] Context result 12

Spastic entropion can be diagnosed through several tests, which are designed to assess the eyelid's position and movement.

• Forceful closure test: This test involves forcefully closing the eyelids, causing override of the pretarsal orbicularis oculi by the preseptal orbicularis. If the entropion persists with eye movements and blinking for at least 3 minutes, a diagnosis of spastic or intermittent entropion can be made [1].
• TIE test: The TIE test is a simple and useful test for the diagnosis of intermittent entropion. It involves asking the patient to close their eyes, and then gently placing the index finger on the upper lid and the thumb on the lower lid [4].
• Snap-back test: This test involves pulling the lower lid away from the globe for several seconds. If there is poor resultant snap back to the globe, it may indicate spastic entropion [6][8].
• Medial canthal laxity test: This test assesses the laxity of the medial canthus and can be used to diagnose spastic entropion [7].

These tests are designed to assess the eyelid's position and movement, and can help healthcare providers diagnose spastic entropion.

Treatment Options for Spastic Entropion

Spastic entropion, a condition where the eyelid turns inward due to spasms in the eyelid muscles, can be treated with various methods. One such treatment is drug therapy.

• Botulinum Toxin (BOTOX): This is a safe and effective temporary solution for spastic entropion. Botulinum toxin injections have been shown to weaken the pretarsal orbicularis oculi muscle, thereby relieving symptoms [6][12]. A study published in 2010 found that botulinum toxin was a highly effective temporary treatment with few complications and no adverse effects on surgical repair results [8].
• Eye Drops: In some cases, eye drops may be prescribed to relieve symptoms of spastic entropion. However, this is usually a temporary solution and not a long-term fix.
• Surgical Repair: While not a drug treatment per se, surgical repair is often the most effective way to treat spastic entropion. The Quickert suture technique is one such method where sutures are placed through the eyelid to tighten the muscles [15].

It's essential to note that the correct treatment approach depends on the underlying cause of the spastic entropion. Identifying and addressing this cause is crucial for effective management.

References:

[6] Botulinum toxin is a safe and effective procedure for correction of some cases of senile and congenital entropion [6]. [8] Botulinum toxin is a highly effective temporary EN treatment with few complications and no adverse effects on the results of surgical EN repair [8]. [12] Small amounts of botulinum toxin (BOTOX) are quite effective for the treatment of spastic entropion by weakening the pretarsal orbicularis oculi muscle [12]. [15] Surgical treatment of choice for spastic entropion is Quickert sutures, possibly coupled with a lateral tarsal strip [15].

Spastic entropion, a condition characterized by inward rotation of the eyelid margin due to sustained orbicularis oculi muscle action, has several differential diagnoses that must be ruled out before its confirmation.

• Epiblepharon: This is a condition where an additional horizontal skin fold overrides the pretarsal muscle, causing the eyelashes to face the globe. It can be differentiated from spastic entropion by the presence of this extra skin fold [1][3].
• Trichiasis: Trichiasis refers to the misdirection of eyelashes without entropion. In this condition, the eyelashes grow inward but do not cause the eyelid to roll inward toward the eye [11][12].
• Distichiasis: This is an anomalous growth of eyelashes that can also be a differential diagnosis for spastic entropion. However, in distichiasis, the extra lashes are usually more pronounced and grow from the meibomian gland orifices [11][12].

It's essential to consider these differential diagnoses when evaluating patients with symptoms suggestive of spastic entropion. A thorough examination and medical history can help differentiate between these conditions and confirm a diagnosis of spastic entropion.

References: [1] Context result 3 [3] Context result 8 [11] Context result 11 [12] Context result 12