1 Involutional Entropion vs Q Involutional Ectropion What does the term Entropion mean? Ectropion 2 Involutional Entropion vs A Involutional Ectropion What does the term Entropion mean? Ectropion It means the eyelid margin is turning inward 3 Involutional Entropion vs Q Involutional Ectropion What does the term What does the term Entropion mean? Ectropion mean? It means the eyelid margin is turning inward 4 Involutional Entropion vs A Involutional Ectropion What does the term What does the term Entropion mean? Ectropion mean? It means the eyelid margin is It means the eyelid margin is turning inward turning outward 5 Involutional Entropion vs Q Involutional Ectropion The Plastics book identifies six general causes of entropion and/or ectropion. What are they? (Note that while most apply to both entropion and ectropion, a few apply only to one or the other.) Entropion Categories Ectropion ? ? ? ? ? ? 6 Involutional Entropion vs A Involutional Ectropion The Plastics book identifies six general causes of entropion and/or ectropion. What are they? (Note that while most apply to both entropion and ectropion, a few apply only to one or the other.) Entropion Categories Ectropion Congenital Involutional Paralytic Cicatricial Mechanical Acute Spastic 7 Involutional Entropion vs Q Involutional Ectropion Of the six, which can result in entropion? Entropion Categories Ectropion ? Congenital ? Involutional ? Paralytic ? Cicatricial ? Mechanical ? Acute Spastic 8 Involutional Entropion vs A Involutional Ectropion Of the six, which can result in entropion? Entropion Categories Ectropion Congenital Congenital Involutional Involutional Paralytic Cicatricial Cicatricial Mechanical Acute Spastic Acute Spastic 9 Involutional Entropion vs Q Involutional Ectropion Of the six, which can result in ectropion? Entropion Categories Ectropion Congenital Congenital ? Involutional Involutional ? Paralytic ? Cicatricial Cicatricial ? Mechanical ? Acute Spastic Acute Spastic ? 10 Involutional Entropion vs A Involutional Ectropion Of the six, which can result in ectropion? Entropion Categories Ectropion Congenital Congenital Congenital Involutional Involutional Involutional Paralytic Paralytic Cicatricial Cicatricial Cicatricial Mechanical Mechanical Acute Spastic Acute Spastic 11 Involutional Entropion vs Involutional Ectropion Entropion Categories Ectropion Congenital Congenital Congenital InvolutionalInvolutional Involutional Let’s take a closerParalytic look at involutionalParalytic entropion vs involutional ectropion… Cicatricial Cicatricial Cicatricial Mechanical Mechanical Acute Spastic Acute Spastic 12 Involutional Entropion vs Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: 13 Involutional Entropion vs Q Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity 14 Involutional Entropion vs A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH 15 Involutional Entropion vs Q Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? 16 Involutional Entropion vs Q/A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. 17 Involutional Entropion vs A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. 18 Involutional Entropion vs Q Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place. (Try it on yourself.) If clinically significant laxity is present, the lid will re-appose the surface in a much less brisk manner. 2) the distraction test 19 Involutional Entropion vs A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place. (Try it on yourself.) If clinically significant laxity is present, the lid will re-appose the surface in a much less brisk manner. 2) the distraction test 20 Involutional Entropion vs Q Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test, which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place. (Try it on yourself.) If clinically significant laxity is present, the lid will re-appose the surface in a much less brisk manner. 2) the distraction test 21 Involutional Entropion vs A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test, which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place. (Try it on yourself.) If clinically significant laxity is present, the lid will re-appose the surface in a much less brisk manner. 2) the distraction test 22 Involutional Entropion vs A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test, which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place. (Try it on yourself.) If clinically significant laxity is present, the lid will re-appose the surface in a much less brisk manner. 2) the distraction test 23 Involutional Entropion vs Q Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test, which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place. (Try it on yourself.) If clinically significant laxity is present, the lid will re-appose the surface in a much less brisk manner. 2) the distraction test: 24 Involutional Entropion vs Q/A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test, which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place. (Try it on yourself.) If clinically significant laxity is present, the lid will re-appose the surface in a much less brisk manner. 2) the distraction test: If the lid can be distracted more than 6distance mm from the ocular surface, it is lax to a clinically significant degree. 25 Involutional Entropion vs A Involutional Ectropion For each of the following, state whether it plays a role in the pathogenesis of lower-lid involutional entropion, lower-lid involutional ectropion, or both: Horizontal lid laxity BOTH How can you assess for horizontal laxity of the lower lid? Very simply: By pulling it away from the globe, ie, by distracting it. This allows assessment of lid tautness via two tests: 1) the snapback test, which is based on the fact that…A taut lower lid will re-appose the globe quickly when released, like a rubber band snapping back into place.