mechanical entropion

Mechanical Entropion: A Condition Where the Eyelid Turns Inward

Mechanical entropion is a type of entropion where the eyelid turns inward due to external forces or masses, such as tumors, scarring, or other physical obstructions. This condition can cause the eyelashes to rub against the eye, leading to irritation, corneal and conjunctival damage, and potentially even loss of vision.

Causes of Mechanical Entropion

Mechanical entropion can be caused by a variety of factors, including:

• Tumors or growths in the orbit or eyelid
• Scarring from previous surgeries or injuries
• Excess upper eyelid skin associated with conditions such as cutis laxa
• Eyelid laxity associated with progeria premature aging syndrome
• Blepharochalasis, a condition characterized by excessive eyelid skin and fat

Symptoms of Mechanical Entropion

The symptoms of mechanical entropion can include:

• Irritation or discomfort in the eye
• Foreign-body sensation caused by inwardly rotated eyelashes
• Corneal and conjunctival damage leading to corneal abrasions, scarring, or neovascularization

Treatment Options for Mechanical Entropion

Treatment options for mechanical entropion may include:

• Surgical correction of the underlying cause (e.g. removal of a tumor)
• Eyelid surgery to return the eyelid to its normal position
• Other treatments such as lubricating eye drops or soft contact lenses to provide moisture and relieve irritation

References:

• [1] Refers to the fact that mechanical entropion is caused by external forces or masses, such as tumors, scarring, or other physical obstructions.
• [3] Mentions that excess upper eyelid skin associated with cutis laxa can cause mechanical entropion.
• [5] and [7] describe mechanical entropion as an inversion of the eyelid margin toward the globe.
• [9] and [11] mention that mechanical entropion can result in trichiasis, where the eyelashes are directed posteriorly toward the globe.

Common Signs and Symptoms of Mechanical Entropion

Mechanical entropion, a type of entropion caused by the inward turning of the eyelid margin, can manifest in various ways. The following are some common signs and symptoms associated with this condition:

• Feeling like something is in your eye: This sensation occurs due to the eyelashes and periocular hair rubbing against the cornea and conjunctiva [6].
• Redness in the eyes: Mechanical entropion can cause irritation, redness, and inflammation of the affected area [8].
• Swollen or hurting eyes: The inward turning of the eyelid margin can lead to discomfort, pain, and swelling around the eye [7].
• Highly sensitive to wind and light: The cornea and conjunctiva may become irritated, making it difficult for individuals with mechanical entropion to tolerate wind, light, or other environmental factors [6][12].
• Stringy white mucoid discharge: This symptom can occur due to the irritation and inflammation caused by the eyelashes rubbing against the cornea and conjunctiva [8].

It's essential to note that these symptoms may vary in severity and can worsen over time if left untreated. If you're experiencing any of these signs and symptoms, it's crucial to consult a medical professional for proper evaluation and treatment.

References: [6] - Context result 6 [7] - Context result 7 [8] - Context result 8 [12] - Context result 12

Diagnostic Tests for Mechanical Entropion

Mechanical entropion, a type of eyelid malposition, can be diagnosed through various tests that assess the eyelid's position, muscle tone, and tightness. Here are some diagnostic tests used to diagnose mechanical entropion:

• Physical Examination: A thorough physical examination by an eye care professional is usually sufficient to diagnose entropion. The doctor may gently tug on your eyelids or ask you to blink or close your eyes forcefully to assess the eyelid's position and muscle tone [10].
• Slit Lamp Examination: A slit lamp examination can help identify involution of the eyelid and lash margin, which is a characteristic feature of mechanical entropion [11].
• Lid Snapback Test: The lid snapback test measures horizontal eyelid laxity. During this test, the examiner pulls the lower eyelid downward and releases it while you inhibit blinking. A normal tension eyelid will immediately snap back to place, whereas an eyelid with increased laxity may require one or more blinks before returning to its normal appositional location against the globe [12].
• Lid Distraction Test: This test assesses tarsal integrity by measuring how quickly the eyelid returns to its anatomical position after being displaced. A diminished tarsal integrity can be detected through this test, which is a defining anatomical defect in involutional entropion [11].

These diagnostic tests help eye care professionals diagnose mechanical entropion and determine the best course of treatment.

References:

[10] - Your doctor may pull on your eyelids during the exam or ask you to blink or close your eyes forcefully. This helps him or her assess your eyelid's position on the eye, its muscle tone and its tightness. [11] - entropion. Diagnosis can be made by identification of involution of the eyelid and lash margin on slit­lamp ex­ amination. Diminished tarsal integrity can be detected by the lid snapback test or the lid distraction test. [12] - The snap-back test will show horizontal eyelid laxity in patients with an entropion.

Differential Diagnoses for Mechanical Entropion

Mechanical entropion, a type of acquired entropion, can be confused with other eyelid malpositions and conditions. To establish an accurate diagnosis, it's essential to rule out the following differential diagnoses:

• Ectropion: An outward turning of the eyelid margin, which can cause similar symptoms due to ocular exposure and inadequate lubrication [9].
• Epiblepharon: A horizontal fold of redundant skin and orbicularis at the eyelid margin, causing the lashes to be directed vertically or invert to a small degree [2].
• Distichiasis: An anomalous growth of eyelashes from the meibomian gland orifices, which can irritate and damage the cornea [1].
• Trichiasis: Misdirection of eyelashes without entropion, where the lashes are directed posteriorly toward the globe [5][10].

These conditions can be ruled out through a thorough eye examination, including external and biomicroscopy evaluation. In the case of mechanical entropion, the eyelid malposition is often visible when the eyelid margin is chronically turned inward, although intermittent cases may appear as if the eyelid is in its normal position adjacent to the globe [13].

Key Points:

• Mechanical entropion can be confused with other eyelid malpositions and conditions.
• Ectropion, epiblepharon, distichiasis, and trichiasis are differential diagnoses that must be ruled out before establishing a diagnosis of mechanical entropion.
• A thorough eye examination is necessary to confirm the diagnosis.

References:

[1] Context 2 [5] Context 5 [9] Context 9 [10] Context 10 [13] Context 13