Involutional Dehisance of posterior lid retractors Laxity of canthal ligaments Vertical lid laxity Atrophy of orbital fat
Tx of involutionalCorrective measure procedureVertical skin-muscle shortening Zieglar cauteryHorizontal tightening of lid at lower bick proceduretarsal border Fox procedure Barricading of orbicularis fibers Weis procedure, Jone’s procedureTightning of orbicularis fibres Wheeler procedureReattachment of inferior retractors Jone’s procedure
Cicatricial• cicatrization of palpebral conjunctiva.(trauma, chemical burns, Stevens-Johnson syndrome, ocular cicatricial pemphigoid (OCP), infections, or local response to topical medication)• Examination of the tarsus and palpebral conjunctiva usually will point to the diagnosis in these cases.
Treatment of cicatritial entropion • Depending on the degree of scarring and entropion, the etiology of the cicatricial changes, and the status of the tarsal plate. • Wedge resection • Tarsal fracture • Wies procedure • More extensive scarring may require oral mucous membrane (eg, buccal mucosa) or cadaveric dermis (eg, Alloderm) grafts.
Spastic entropion ocular irritation in the form of inflammation trauma Recent surgery Tight bandaging or due to degeneration of palpebral connective tissue separating the fibers of orbicularis muscle Age related degeneration of tarsal muscle