LecturePatient will present as → a 75-year-old with a foreign body sensation and tearing of his right eye. On physical exam you note a red, irritated, right eye in association with an inverted eyelid.
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Entropion (inversion of an eyelid) is caused by age-related tissue relaxation, postinfectious or posttraumatic changes, or blepharospasm.
- Eyelid turned in
- Eyelashes rub against the eyeball and may lead to corneal ulceration and scarring
- Symptoms can include foreign body sensation, tearing, and red eye.
The eyelid of entropion may cause irritation due to rubbing of the eyelashes
Diagnosis is clinical (eyelids turn in)
TX: tear supplements and ocular lubricants at night
- Definitive treatment is surgery
Question 1 |
A 71-year-old male presents to your office complaining of excessive tearing and a left eye that always "feels like I have a grain of sand it." On exam, the conjunctiva appears red, and the left eyelid is inward turning. You note corneal ulceration. What is the best course of action at this time?
Immediate referral to ophthalmology for surgical correction | |
Prescribe artificial tears and follow up in 3 months Hint: See A for explanation | |
Prescribe a short course of corticosteroid eye drops Hint: Corticosteroid eye drops are not indicated in the treatment of entropion | |
Have the patient instill Tobramycin eye drops for 5 days Hint: Antibiotic eye drops are not indicated in the treatment of entropion |
Question 1 Explanation:
The physical exam is consistent with entropion along with corneal ulceration that may lead to permanent scarring. The patient should be referred to ophthalmology for immediate surgical correction.
There is 1 question to complete.
References: Merck Manual · UpToDate
