Entropion – Epidemiologia

Entropion
Epidemiologia

Entropion, definiowany jako podwinięcie powieki do wewnątrz, jest schorzeniem okulistycznym o częstości występowania około 2% w populacji ogólnej, ze wzrostem do 2,1% u osób powyżej 60. roku życia, a nawet do 7,6-11% u pacjentów powyżej 80 lat. Częstość występowania jest wyższa u kobiet (2,4%) niż u mężczyzn (1,9%) oraz różni się etnicznie – entropion inwolucyjny dotyczy 2,4% osób rasy białej i 0,8% rasy czarnej. Schorzenie występuje częściej obustronnie niż jednostronnie (3:1). Główne typy entropionu to inwolucyjny (najczęstszy, 78,57% przypadków), bliznowaty (związany m.in. z jaglicą – zakażeniem Chlamydia trachomatis), spastyczny oraz wrodzony (bardzo rzadki). Diagnostyka opiera się na badaniu klinicznym, w tym testach takich jak snap-back, dystrakcji powieki, cyfrowej ewersji oraz orbicularis override test. W przypadku entropionu bliznowatego wskazane są badania w kierunku infekcji i chorób autoimmunologicznych.

Epidemiologia entropionu

Rozkład geograficzny i populacyjny
Rodzaje entropionu i ich epidemiologia
Czynniki ryzyka i współchorobowość
Nadzór i wykrywanie
Powikłania i rokowanie
Entropion w medycynie weterynaryjnej
Kolejne rozdziały

Epidemiologia entropionu

Entropion, charakteryzujący się podwinięciem powieki do wewnątrz, jest stosunkowo powszechnym schorzeniem okulistycznym, którego częstość występowania wzrasta wraz z wiekiem. W populacji ogólnej entropion dotyka około 2% osób, jednak wśród osób powyżej 60. roku życia odsetek ten wzrasta do około 2,1%.¹² U osób w wieku 60-69 lat częstość występowania wynosi 0,9%, w wieku 70-79 lat wzrasta do 2,1%, a u osób powyżej 80. roku życia osiąga nawet 7,6%.³ Niektóre źródła wskazują, że w grupie osób powyżej 80 lat częstość występowania może sięgać nawet 11%.⁴

Rozkład geograficzny i populacyjny

Entropion występuje na całym świecie, jednak jego częstość może różnić się w zależności od regionu geograficznego.⁵ W niektórych częściach Afryki i Azji częstość występowania entropionu jest wyższa niż w innych regionach, co związane jest m.in. z większą częstością występowania jaglicy (zakażenia Chlamydia trachomatis), która jest istotnym czynnikiem ryzyka entropionu bliznowatego.⁶⁷

Badania wykazały, że entropion częściej występuje u kobiet niż u mężczyzn, z częstością występowania 2,4% u kobiet w porównaniu do 1,9% u mężczyzn.⁸⁹ Jedna z teorii wyjaśniających tę różnicę sugeruje, że kobiety mają zazwyczaj mniejsze płytki tarczkowe niż mężczyźni, co może zwiększać podatność na rozwój entropionu.¹⁰ Warto zaznaczyć, że entropion inwolucyjny jest częstszy u kobiet, podczas gdy ektropion inwolucyjny częściej dotyka mężczyzn.¹¹

Entropion inwolucyjny ma częstość występowania 2,4% u osób rasy białej i 0,8% u osób rasy czarnej, co wskazuje na różnice etniczne w podatności na tę chorobę.¹² Entropion występuje również częściej obustronnie niż jednostronnie – choroba obustronna jest trzy razy częstsza niż jednostronna.¹³¹⁴

Rodzaje entropionu i ich epidemiologia

Entropion można sklasyfikować według etiologii na kilka głównych typów, które różnią się częstością występowania:

Entropion inwolucyjny (związany z wiekiem) – najczęstsza forma entropionu, występująca głównie u osób powyżej 60. roku życia. Stanowi największy odsetek przypadków (około 2,1% populacji osób starszych).¹⁵¹⁶
Entropion bliznowaty (cicatricial) – związany z bliznowaceniem powiek na skutek infekcji (np. jaglicy), urazów, oparzeń chemicznych i termicznych, chorób autoimmunologicznych (np. pemfigoid bliznowaciejący) i innych stanów okulistycznych.¹⁷¹⁸
Entropion spastyczny – może występować wtórnie do przewlekłego entropionu inwolucyjnego lub jako reakcja na ból oczny, np. po zabiegach chirurgicznych.¹⁹²⁰
Entropion wrodzony – bardzo rzadka forma, z mniej niż 50 przypadkami opisanymi na całym świecie.²¹ Częściej dotyczy powieki dolnej niż górnej i może być jednostronny lub obustronny.²²

Entropion bliznowaty związany z jaglicą (zakażeniem Chlamydia trachomatis) jest istotnym problemem w wielu krajach rozwijających się. Jaglica jest najczęstszą przyczyną zakaźnej ślepoty na świecie i według szacunków Światowej Organizacji Zdrowia (WHO) dotyka około 10 milionów ludzi.²³ Warto jednak zauważyć, że nie wszystkie przypadki trichiasis spowodowanego jaglicą są związane z entropionem – badania wykazały, że u wielu pacjentów z trichiasis wywołanym jaglicą entropion jest minimalny lub nie występuje wcale.²⁴²⁵

Entropion senilny (związany ze starzeniem się) stanowi najwyższy odsetek wśród przyczyn entropionu, sięgający 78,57% wszystkich przypadków.²⁶

Czynniki ryzyka i współchorobowość

Główne czynniki ryzyka rozwoju entropionu obejmują:

Zaawansowany wiek (szczególnie powyżej 60 lat)²⁷²⁸
Płeć żeńska²⁹
Wcześniejsze oparzenia lub urazy powiek³⁰
Infekcja jaglicza³¹
Przewlekłe stany zapalne powiek³²
Choroby autoimmunologiczne³³

Pacjenci z entropionem inwolucyjnym często mają znaczące choroby współistniejące. Zaobserwowano, że 4-letnia śmiertelność dla pacjentów z entropionem inwolucyjnym wynosi 30%, co wskazuje na potencjalny związek z ogólnym stanem zdrowia.³⁴

Nadzór i wykrywanie

Wczesne wykrywanie entropionu jest kluczowe dla zapobiegania powikłaniom, takim jak uszkodzenia rogówki, infekcje oka, owrzodzenia rogówki, a w skrajnych przypadkach nawet trwała utrata wzroku.³⁵³⁶

Diagnostyka entropionu opiera się głównie na badaniu klinicznym, obejmującym ocenę zewnętrzną i biomikroskopową. Testy fizyczne stosowane do oceny podwiniętych brzegów powiek obejmują:

Test odskoku (snap-back test)
Test dystrakcji powieki
Test cyfrowej ewersji
Test przewagi mięśnia okrężnego oka (orbicularis override test)³⁷

Badania laboratoryjne zazwyczaj nie są potrzebne do zdiagnozowania entropionu. Jednak w przypadku entropionu bliznowatego mogą być konieczne testy w kierunku infekcji lub chorób autoimmunologicznych przed zaleceniem leczenia.³⁸

Pacjenci z objawowym entropionem lub z ryzykiem uszkodzenia rogówki powinni być kierowani do specjalisty.³⁹ Według niektórych szacunków, do 2,1% osób dorosłych powyżej 60. roku życia jest diagnozowanych z entropionem.⁴⁰

Powikłania i rokowanie

Nieleczony entropion może prowadzić do poważnych powikłań, takich jak:

Infekcje oczu
Uszkodzenia rogówki i owrzodzenia rogówki
Trwała utrata wzroku⁴¹

Entropion może powodować owrzodzenie rogówki, które może ulec infekcji i prowadzić do ciężkiej utraty wzroku, jeśli pacjent nie otrzyma szybkiego leczenia.⁴²

Ogólny odsetek powikłań dotyczących spojówki i rogówki jest niższy w przypadku entropionu niż ektropionu.⁴³

Rokowanie w przypadku entropionu może się różnić w zależności od nasilenia stanu i przyczyny podstawowej. Jednak przy odpowiednim leczeniu większość przypadków entropionu może być skutecznie leczona, a powikłania zminimalizowane.⁴⁴

Badania wykazały znaczącą pooperacyjną redukcję nasilenia wszystkich subiektywnie ocenianych objawów według skali VAS oraz poprawę w dziedzinach somatycznej, psychologicznej i środowiskowej kwestionariusza WHOQOL-BREF po leczeniu chirurgicznym entropionu.⁴⁵

Entropion w medycynie weterynaryjnej

Warto nadmienić, że entropion występuje również u zwierząt, szczególnie u psów i kotów. W badaniu retrospektywnym przeprowadzonym w Szpitalu Weterynaryjnym Uniwersytetu Federalnego w Jataí w latach 2013-2020, entropion stanowił 6,2% wszystkich przypadków okulistycznych. Najczęściej dotkniętymi rasami psów były Shar-Pei i Chow Chow.⁴⁶

Większość przypadków pierwotnego entropionu u zwierząt jest związana z rasą i ma komponent dziedziczny. Nie jest rzadkością, gdy kilka spokrewnionych zwierząt jest dotkniętych entropionem, a hodowla takich osobników jest odradzana.⁴⁷

U bydła entropion może występować jednostronnie lub obustronnie, najczęściej dotyczy dolnej powieki. Zwykle dotknięte jest pojedyncze zwierzę, choć można zauważyć tendencje w liniach genetycznych.⁴⁸

Grupa wiekowa	Częstość występowania entropionu
Populacja ogólna	~2%
Osoby 60-69 lat	0,9%
Osoby 70-79 lat	2,1%
Osoby powyżej 80 lat	7,6-11%
Płeć	Częstość występowania
Kobiety	2,4%
Mężczyźni	1,9%
Grupa etniczna	Częstość występowania entropionu inwolucyjnego
Osoby rasy białej	2,4%
Osoby rasy czarnej	0,8%

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Materiały źródłowe

#1 Entropion – EyeWiki
https://eyewiki.org/Entropion
In a study of nearly 25,000 individuals over 60 years old, involutional entropion was found in 2.1% of patients, lesser than involutional ectropion. Prevalence increased with age: 0.9% for patient 60-69 years old, 2.1% for 70-79, and 7.6% for those over 80. Bilateral disease is three times more common than unilateral. Entropion is more common in women, with prevalence 2.4%, compared to 1.9% in men. Involutional entropion has a reported prevalence of 2.4% in whites and 0.8% in blacks. […] Patients with involutional entropion are often elderly and have significant comorbidities. The 4-year mortality for patients with involutional entropion is 30%.
#2 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Presenting symptoms of entropion include foreign body sensation, tearing, red eye, and irritation. […] Its prevalence increases with age and is more common in women. […] Unilateral occurrence of entropion is less likely than bilateral presentation. […] The development of entropion can occur from involutional, cicatricial, spastic, or congenital etiologies. […] Involutional entropion is the most common form of entropion and appears in advancing age, especially in patients who are 60 years and older. […] It exists in 2.1% of the elderly population. […] Spastic entropion can occur secondary to a chronically occurring involutional entropion. […] Congenital entropion is caused by abnormal eyelid development. […] With less than 50 cases reported worldwide, congenital entropion is rare.
#3 Entropion – EyeWiki
https://eyewiki.org/Entropion
In a study of nearly 25,000 individuals over 60 years old, involutional entropion was found in 2.1% of patients, lesser than involutional ectropion. Prevalence increased with age: 0.9% for patient 60-69 years old, 2.1% for 70-79, and 7.6% for those over 80. Bilateral disease is three times more common than unilateral. Entropion is more common in women, with prevalence 2.4%, compared to 1.9% in men. Involutional entropion has a reported prevalence of 2.4% in whites and 0.8% in blacks. […] Patients with involutional entropion are often elderly and have significant comorbidities. The 4-year mortality for patients with involutional entropion is 30%.
#4 Entropion – College of Optometrists
https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/entropion
Entropion is most commonly caused by loss of eyelid elasticity and muscle tone as part of the ageing process. Prevalence is approximately 2% in the over 60s and 11% in those aged over 80. […] This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating entropion. […] In many countries of the world entropion occurs as a complication of repeated infection by the trachoma agent (Chlamydia trachomatis). […] Patients are often referred routinely to the ophthalmologist for consideration of surgery, usually under local anaesthetic, which may solve the problem.
#5 What is Entropion? | iSIGHT Clinic
https://www.isightclinics.com/what-is-entropion
The prevalence of entropion, (flipped eyelids) varies by age, geographic region, and underlying medical conditions. Generally, it is more common in older adults due to age-related changes in the eyelid tissues. In some parts of the world, such as Africa and Asia, the prevalence of entropion is higher than in other regions. […] According to some estimates, the overall prevalence of entropion in the general population is around 2%, but it may be as high as 20% in some older populations. However, the exact prevalence of entropion can vary depending on the study population, diagnostic criteria, and methodology used to identify the condition. […] The prevalence of entropion in the UK is not well documented, but it is estimated to be like that of other developed countries. According to some studies, the prevalence of entropion in the general population ranges from 0.9% to 2.1%, but the prevalence increases with age, particularly in those aged 60 years and older. […] In addition, entropion may be more common in certain ethnic groups, such as those of African or Asian descent. There may also be regional variations in the prevalence of entropion within the UK.
#6 Entropion – College of Optometrists
https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/entropion
Entropion is most commonly caused by loss of eyelid elasticity and muscle tone as part of the ageing process. Prevalence is approximately 2% in the over 60s and 11% in those aged over 80. […] This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating entropion. […] In many countries of the world entropion occurs as a complication of repeated infection by the trachoma agent (Chlamydia trachomatis). […] Patients are often referred routinely to the ophthalmologist for consideration of surgery, usually under local anaesthetic, which may solve the problem.
#7 Trichiasis – EyeWiki
https://eyewiki.org/Trichiasis
While the frequency of trichiasis is not known, trachoma is the most common cause of infectious blindness worldwide. It is the result of infection by the intracellular obligate bacteria Chlamydia Trachomatis and is thought to affect approximately 10 million people. As part of the World Health Organizations effort to eliminate trachoma by 2020, they estimate there is presently about 3.2 million surgery backlog. Women are four times more affected than males. […] Eyelash trichiasis may also be a result of topical prostaglandin use, or other chronic eyelid/eyelash inflammation.
#8 Entropion, Abnormalities of the Eyelids – EMC Healthcare – SAME
https://www.emc.id/en/care-plus/entropion-abnormalities-of-the-eyelids
Entropion most commonly occurs at an average age of 60 years and over. The prevalence increases as a person gets older. Entropion occurs more often in women with a prevalence of 2.4% compared to men (1.9%). Entropion occurs more often on the lower lids, but can also occur on the upper lids. Apart from that, entropion can also be related to conditions resulting from traumatic lacerations and infections of the eyelids. […] Entropion that is treated too late or is not treated properly can potentially cause complications, including: Eye infections, Corneal injuries and corneal ulcers, Permanent blindness.
#9 Entropion – EyeWiki
https://eyewiki.org/Entropion
In a study of nearly 25,000 individuals over 60 years old, involutional entropion was found in 2.1% of patients, lesser than involutional ectropion. Prevalence increased with age: 0.9% for patient 60-69 years old, 2.1% for 70-79, and 7.6% for those over 80. Bilateral disease is three times more common than unilateral. Entropion is more common in women, with prevalence 2.4%, compared to 1.9% in men. Involutional entropion has a reported prevalence of 2.4% in whites and 0.8% in blacks. […] Patients with involutional entropion are often elderly and have significant comorbidities. The 4-year mortality for patients with involutional entropion is 30%.
#10 Entropion | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/21165
The older an individual is, the greater the chances of developing an entropion. […] Bilateral disease is three times more common than unilateral. […] Entropion is thought to occur more frequently in women than men, as women tend to have smaller tarsal plates than men.
#11 Arquivos Brasileiros de Oftalmologia – Eyelid aging: pathophysiology and clinical management
https://www.aboonline.org.br/details/2117/en-US/eyelid-aging–pathophysiology-and-clinical-management
Dermatochalasis, ptosis, ectropion, and entropion are common disorders in middle-aged and older adults. The overall prevalence of sagging eyelids among individuals aged 45 years is reported to be 16%, comprising 19% of men and 14% of women. […] Two large epidemiologic studies – the Rotterdam study and the Twins UK study – dealt with the prevalence and risk factors for sagging eyelids. […] By studying these populations, many non-genetic risk factors for sagging eyelids could be discerned, including age, high body mass index, lighter skin color, smoking, male gender, and heritability. […] The prevalence of involutional ectropion seems to be similar to that of involutional entropion. […] The literature suggests that the prevalence of ectropion is about 4% in patients older than 49 years, not differing among the different ectropion forms or regarding the underlying etiology. […] Males are more often affected by involutional ectropion. In contrast, involutional entropion is more often seen in women. […] The prevalence of involutional ectropion and entropion increases with the patient’s age, which is the logical order for involutional malformations to increase with age.
#12 Entropion – EyeWiki
https://eyewiki.org/Entropion
In a study of nearly 25,000 individuals over 60 years old, involutional entropion was found in 2.1% of patients, lesser than involutional ectropion. Prevalence increased with age: 0.9% for patient 60-69 years old, 2.1% for 70-79, and 7.6% for those over 80. Bilateral disease is three times more common than unilateral. Entropion is more common in women, with prevalence 2.4%, compared to 1.9% in men. Involutional entropion has a reported prevalence of 2.4% in whites and 0.8% in blacks. […] Patients with involutional entropion are often elderly and have significant comorbidities. The 4-year mortality for patients with involutional entropion is 30%.
#13 Entropion | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/21165
The older an individual is, the greater the chances of developing an entropion. […] Bilateral disease is three times more common than unilateral. […] Entropion is thought to occur more frequently in women than men, as women tend to have smaller tarsal plates than men.
#14 Entropion – EyeWiki
https://eyewiki.org/Entropion
In a study of nearly 25,000 individuals over 60 years old, involutional entropion was found in 2.1% of patients, lesser than involutional ectropion. Prevalence increased with age: 0.9% for patient 60-69 years old, 2.1% for 70-79, and 7.6% for those over 80. Bilateral disease is three times more common than unilateral. Entropion is more common in women, with prevalence 2.4%, compared to 1.9% in men. Involutional entropion has a reported prevalence of 2.4% in whites and 0.8% in blacks. […] Patients with involutional entropion are often elderly and have significant comorbidities. The 4-year mortality for patients with involutional entropion is 30%.
#15 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Presenting symptoms of entropion include foreign body sensation, tearing, red eye, and irritation. […] Its prevalence increases with age and is more common in women. […] Unilateral occurrence of entropion is less likely than bilateral presentation. […] The development of entropion can occur from involutional, cicatricial, spastic, or congenital etiologies. […] Involutional entropion is the most common form of entropion and appears in advancing age, especially in patients who are 60 years and older. […] It exists in 2.1% of the elderly population. […] Spastic entropion can occur secondary to a chronically occurring involutional entropion. […] Congenital entropion is caused by abnormal eyelid development. […] With less than 50 cases reported worldwide, congenital entropion is rare.
#16 Causes, symptoms and details of Entropion – Pulse Reference
https://pulsereference.com/diagnoses/entropion/
Entropion predominantly affects the elderly, with a higher incidence in those over 60 years of age. […] Involutional entropion is the most common type, linked to age-related changes in eyelid tissue. […] Cicatricial entropion, though less common, is associated with ocular scarring due to infections, trauma or autoimmune conditions.
#17 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Cicatricial entropion can develop secondary to a history or presence of infections, such as trachoma, inflammatory diseases such as Stevens-Johnson syndrome, chemical and thermal burn, autoimmune diseases such as ocular cicatricial pemphigoid, and other eye conditions. […] The posterior lamella vertically contracts from eyelid scarring, which leads to cicatricial development. […] Entropion can be identified on external and biomicroscopy evaluation. […] Physical examinations to assess inverted eyelid margins include: Snap-back test, Eyelid distraction test, Digital eversion test, Orbicularis override test. […] If the eyelid does not return to its position apposed to the globe in 1 to 2 seconds, there is pathological laxity. […] Eyelid laxity can also be assessed by the eyelid dislocation or distraction test. […] Non-surgical management of entropion includes topical lubricating gels and ointments with or without bandage contact lenses. […] Surgical repair is the only treatment that offers long-term results. […] Ultimately, surgery offers a better chance for long-term treatment of entropion.
#18 Entropion – Valerie Vick, MD
https://valerievick.com/entropion/
Cicatricial entropion related to scarring e.g. due to accident burns or surgery (recall that cicatrix is the medical term for a scar). Either one or both eyes may be affected. […] Spastic entropion of the lower-eyelid may be due to (possibly temporary) spasm of the orbicularis oculus muscle, e.g. following surgery. […] Congenital entropion that is, entropion present since birth. This is very rare but when present may be due to hypertrophy, i.e. increased size (due to enlargement of the cells) of the skin of the affected area or the orbicularis oculi muscles responsible for opening/closing the eyes. Either one, or both, eyes may be affected.
#19 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Presenting symptoms of entropion include foreign body sensation, tearing, red eye, and irritation. […] Its prevalence increases with age and is more common in women. […] Unilateral occurrence of entropion is less likely than bilateral presentation. […] The development of entropion can occur from involutional, cicatricial, spastic, or congenital etiologies. […] Involutional entropion is the most common form of entropion and appears in advancing age, especially in patients who are 60 years and older. […] It exists in 2.1% of the elderly population. […] Spastic entropion can occur secondary to a chronically occurring involutional entropion. […] Congenital entropion is caused by abnormal eyelid development. […] With less than 50 cases reported worldwide, congenital entropion is rare.
#20 Entropion – Valerie Vick, MD
https://valerievick.com/entropion/
Cicatricial entropion related to scarring e.g. due to accident burns or surgery (recall that cicatrix is the medical term for a scar). Either one or both eyes may be affected. […] Spastic entropion of the lower-eyelid may be due to (possibly temporary) spasm of the orbicularis oculus muscle, e.g. following surgery. […] Congenital entropion that is, entropion present since birth. This is very rare but when present may be due to hypertrophy, i.e. increased size (due to enlargement of the cells) of the skin of the affected area or the orbicularis oculi muscles responsible for opening/closing the eyes. Either one, or both, eyes may be affected.
#21 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Presenting symptoms of entropion include foreign body sensation, tearing, red eye, and irritation. […] Its prevalence increases with age and is more common in women. […] Unilateral occurrence of entropion is less likely than bilateral presentation. […] The development of entropion can occur from involutional, cicatricial, spastic, or congenital etiologies. […] Involutional entropion is the most common form of entropion and appears in advancing age, especially in patients who are 60 years and older. […] It exists in 2.1% of the elderly population. […] Spastic entropion can occur secondary to a chronically occurring involutional entropion. […] Congenital entropion is caused by abnormal eyelid development. […] With less than 50 cases reported worldwide, congenital entropion is rare.
#22
https://journals.lww.com/ijog/fulltext/2024/04020/congenital_lower_eyelid_entropion_with_corneal.43.aspx
Congenital entropion is a rare condition affecting the lower eyelid more commonly than the upper eyelid. […] Congenital eyelid entropion is rare, affecting the lower eyelid more commonly than the upper eyelid, and can be unilateral or bilateral. […] Diagnosing congenital entropion in a neonate is difficult due to poor visualization of the eyelid margin in a crying child. […] Surgery for congenital entropion may be recommended given the risk of corneal ulceration. […] There are few case reports of congenital lower lid entropion with corneal ulceration. […] Ophthalmologists should be aware of the possibility of congenital entropion given the diagnostic difficulty and risk of vision loss from corneal ulceration and scarring. […] Quickert sutures are an effective way of treating congenital entropion in the neonatal age group.
#23 Trichiasis – EyeWiki
https://eyewiki.org/Trichiasis
While the frequency of trichiasis is not known, trachoma is the most common cause of infectious blindness worldwide. It is the result of infection by the intracellular obligate bacteria Chlamydia Trachomatis and is thought to affect approximately 10 million people. As part of the World Health Organizations effort to eliminate trachoma by 2020, they estimate there is presently about 3.2 million surgery backlog. Women are four times more affected than males. […] Eyelash trichiasis may also be a result of topical prostaglandin use, or other chronic eyelid/eyelash inflammation.
#24 LSHTM LSHTM Research Online
https://researchonline.lshtm.ac.uk/244/
PURPOSE: Trachomatous trichiasis (TT) is usually described as a cicatricial entropion of the upper lid; however, other forms of trichiasis have been reported. […] Many patients with TT have minimal or no entropion. The trichiasis is frequently attributable to metaplastic or misdirected eyelashes.
#25 The Clinical Phenotype of Trachomatous Trichiasis in Ethiopia: Not All Trichiasis Is Due to Entropion | Scilit
https://www.scilit.com/publications/7e1101c4404bfd37aed31e954fda3519
Purpose.: Trachomatous trichiasis (TT) is usually described as a cicatricial entropion of the upper lid; however, other forms of trichiasis have been reported. […] Entropion was absent or mild in 2328 (54.0%) eyes, moderate in 1259 (29.2%) eyes, and severe in 723 (16.8%) eyes. […] Many patients with TT have minimal or no entropion.
#26 A study of the various etiologies and sequelae to ectropion and entropion. – Document – Gale OneFile: Health and Medicine
https://go.gale.com/ps/i.do?id=GALE%7CA687781839&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=25894528&p=HRCA&sw=w
The prevalence of ectropion and entropion put together was 0.064%. […] The senile cause is the highest (78.57%) among the etiologies of entropion. […] Eyelid malpositions have a low prevalence of 0.064%. […] The overall percentage of conjunctival and corneal complications was found to be significantly higher in ectropion than in entropion.
#27 Entropion, Abnormalities of the Eyelids – EMC Healthcare – SAME
https://www.emc.id/en/care-plus/entropion-abnormalities-of-the-eyelids
Entropion most commonly occurs at an average age of 60 years and over. The prevalence increases as a person gets older. Entropion occurs more often in women with a prevalence of 2.4% compared to men (1.9%). Entropion occurs more often on the lower lids, but can also occur on the upper lids. Apart from that, entropion can also be related to conditions resulting from traumatic lacerations and infections of the eyelids. […] Entropion that is treated too late or is not treated properly can potentially cause complications, including: Eye infections, Corneal injuries and corneal ulcers, Permanent blindness.
#28 What is Entropion? – Optometrists.org
https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/dry-eye/eyelid-conditions/what-is-entropion/
Entropion is an eyelid condition that impacts the lives of over 1 in 50 of all adults. […] The following factors can increase your risk of ectropion: Age, in particular above 60, Previous burns or trauma, Trachoma infection. […] Entropion poses a risk to the cornea and can lead to ocular damage, infection and permanent vision loss, if left untreated.
#29 Entropion – EyeWiki
https://eyewiki.org/Entropion
In a study of nearly 25,000 individuals over 60 years old, involutional entropion was found in 2.1% of patients, lesser than involutional ectropion. Prevalence increased with age: 0.9% for patient 60-69 years old, 2.1% for 70-79, and 7.6% for those over 80. Bilateral disease is three times more common than unilateral. Entropion is more common in women, with prevalence 2.4%, compared to 1.9% in men. Involutional entropion has a reported prevalence of 2.4% in whites and 0.8% in blacks. […] Patients with involutional entropion are often elderly and have significant comorbidities. The 4-year mortality for patients with involutional entropion is 30%.
#30 What is Entropion? – Optometrists.org
https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/dry-eye/eyelid-conditions/what-is-entropion/
Entropion is an eyelid condition that impacts the lives of over 1 in 50 of all adults. […] The following factors can increase your risk of ectropion: Age, in particular above 60, Previous burns or trauma, Trachoma infection. […] Entropion poses a risk to the cornea and can lead to ocular damage, infection and permanent vision loss, if left untreated.
#31 Entropion – College of Optometrists
https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/entropion
Entropion is most commonly caused by loss of eyelid elasticity and muscle tone as part of the ageing process. Prevalence is approximately 2% in the over 60s and 11% in those aged over 80. […] This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating entropion. […] In many countries of the world entropion occurs as a complication of repeated infection by the trachoma agent (Chlamydia trachomatis). […] Patients are often referred routinely to the ophthalmologist for consideration of surgery, usually under local anaesthetic, which may solve the problem.
#32 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Cicatricial entropion can develop secondary to a history or presence of infections, such as trachoma, inflammatory diseases such as Stevens-Johnson syndrome, chemical and thermal burn, autoimmune diseases such as ocular cicatricial pemphigoid, and other eye conditions. […] The posterior lamella vertically contracts from eyelid scarring, which leads to cicatricial development. […] Entropion can be identified on external and biomicroscopy evaluation. […] Physical examinations to assess inverted eyelid margins include: Snap-back test, Eyelid distraction test, Digital eversion test, Orbicularis override test. […] If the eyelid does not return to its position apposed to the globe in 1 to 2 seconds, there is pathological laxity. […] Eyelid laxity can also be assessed by the eyelid dislocation or distraction test. […] Non-surgical management of entropion includes topical lubricating gels and ointments with or without bandage contact lenses. […] Surgical repair is the only treatment that offers long-term results. […] Ultimately, surgery offers a better chance for long-term treatment of entropion.
#33 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Cicatricial entropion can develop secondary to a history or presence of infections, such as trachoma, inflammatory diseases such as Stevens-Johnson syndrome, chemical and thermal burn, autoimmune diseases such as ocular cicatricial pemphigoid, and other eye conditions. […] The posterior lamella vertically contracts from eyelid scarring, which leads to cicatricial development. […] Entropion can be identified on external and biomicroscopy evaluation. […] Physical examinations to assess inverted eyelid margins include: Snap-back test, Eyelid distraction test, Digital eversion test, Orbicularis override test. […] If the eyelid does not return to its position apposed to the globe in 1 to 2 seconds, there is pathological laxity. […] Eyelid laxity can also be assessed by the eyelid dislocation or distraction test. […] Non-surgical management of entropion includes topical lubricating gels and ointments with or without bandage contact lenses. […] Surgical repair is the only treatment that offers long-term results. […] Ultimately, surgery offers a better chance for long-term treatment of entropion.
#34 Entropion – EyeWiki
https://eyewiki.org/Entropion
In a study of nearly 25,000 individuals over 60 years old, involutional entropion was found in 2.1% of patients, lesser than involutional ectropion. Prevalence increased with age: 0.9% for patient 60-69 years old, 2.1% for 70-79, and 7.6% for those over 80. Bilateral disease is three times more common than unilateral. Entropion is more common in women, with prevalence 2.4%, compared to 1.9% in men. Involutional entropion has a reported prevalence of 2.4% in whites and 0.8% in blacks. […] Patients with involutional entropion are often elderly and have significant comorbidities. The 4-year mortality for patients with involutional entropion is 30%.
#35 Entropion, Abnormalities of the Eyelids – EMC Healthcare – SAME
https://www.emc.id/en/care-plus/entropion-abnormalities-of-the-eyelids
Entropion most commonly occurs at an average age of 60 years and over. The prevalence increases as a person gets older. Entropion occurs more often in women with a prevalence of 2.4% compared to men (1.9%). Entropion occurs more often on the lower lids, but can also occur on the upper lids. Apart from that, entropion can also be related to conditions resulting from traumatic lacerations and infections of the eyelids. […] Entropion that is treated too late or is not treated properly can potentially cause complications, including: Eye infections, Corneal injuries and corneal ulcers, Permanent blindness.
#36 What is Entropion? – Optometrists.org
https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/dry-eye/eyelid-conditions/what-is-entropion/
Entropion is an eyelid condition that impacts the lives of over 1 in 50 of all adults. […] The following factors can increase your risk of ectropion: Age, in particular above 60, Previous burns or trauma, Trachoma infection. […] Entropion poses a risk to the cornea and can lead to ocular damage, infection and permanent vision loss, if left untreated.
#37 A Clinical Guide to Entropion
https://eyesoneyecare.com/resources/clinical-guide-to-entropion/
Cicatricial entropion can develop secondary to a history or presence of infections, such as trachoma, inflammatory diseases such as Stevens-Johnson syndrome, chemical and thermal burn, autoimmune diseases such as ocular cicatricial pemphigoid, and other eye conditions. […] The posterior lamella vertically contracts from eyelid scarring, which leads to cicatricial development. […] Entropion can be identified on external and biomicroscopy evaluation. […] Physical examinations to assess inverted eyelid margins include: Snap-back test, Eyelid distraction test, Digital eversion test, Orbicularis override test. […] If the eyelid does not return to its position apposed to the globe in 1 to 2 seconds, there is pathological laxity. […] Eyelid laxity can also be assessed by the eyelid dislocation or distraction test. […] Non-surgical management of entropion includes topical lubricating gels and ointments with or without bandage contact lenses. […] Surgical repair is the only treatment that offers long-term results. […] Ultimately, surgery offers a better chance for long-term treatment of entropion.
#38 Entropion – MD Searchlight
https://mdsearchlight.com/eye-health/entropion/
Entropion is a condition where the eyelid folds inward. […] Entropion is more likely to occur as people age and tends to affect women more than men. […] Lab tests are typically not needed to diagnose entropion. However, if the entropion is caused by scarring (cicatricial entropion), tests for infections or autoimmune diseases may be necessary before treatment is prescribed. […] The prognosis for Entropion can vary depending on the severity of the condition and the underlying cause. However, with proper treatment, most cases of Entropion can be managed effectively and complications can be minimized.
#39 Entropion | Tidsskrift for Den norske legeforening
https://tidsskriftet.no/en/2024/12/clinical-review/entropion
Entropion, or the inward turning of the eyelid, is common, particularly in older patients. […] Entropion affects approximately 3 % of the population aged over 65 years. The prevalence increases with age and is more common in women than men. […] Patients with entropion should be referred to a specialist if their condition is symptomatic or the cornea is at risk. […] The treatment of entropion is tailored to the individual circumstances and will depend on the examination findings, subtype, comorbidities and how comfortable the patient is with the extensiveness of a procedure. […] Entropion is a common condition, particularly in older patients. It is classified as involutional (age-related), cicatricial (scar-related), spastic or congenital. Treatment is selected on the basis of aetiology and subtype. Temporary measures should be considered to prevent corneal injury in patients awaiting surgical correction.
#40 Entropion: Diagnosis and Treatment – Optometrists.org
https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/dry-eye/eyelid-conditions/entropion-diagnosis-and-treatment/
Up to 2.1 percent of adults over age 60 are diagnosed with entropion. […] Diagnosis of the cause of the eyelashes facing inward is vital as this could be due to a benign growth or cancer of the eyelids. […] If you have noticed any changes in the appearance of your eyelids, schedule an appointment with an eye doctor near you for a proper diagnosis and effective treatment plan.
#41 Entropion, Abnormalities of the Eyelids – EMC Healthcare – SAME
https://www.emc.id/en/care-plus/entropion-abnormalities-of-the-eyelids
Entropion most commonly occurs at an average age of 60 years and over. The prevalence increases as a person gets older. Entropion occurs more often in women with a prevalence of 2.4% compared to men (1.9%). Entropion occurs more often on the lower lids, but can also occur on the upper lids. Apart from that, entropion can also be related to conditions resulting from traumatic lacerations and infections of the eyelids. […] Entropion that is treated too late or is not treated properly can potentially cause complications, including: Eye infections, Corneal injuries and corneal ulcers, Permanent blindness.
#42 Entropion: Symptoms, causes, and treatment
https://www.medicalnewstoday.com/articles/248936
Entropion is very rare in children and young adults, but it may affect up to 2.1 percent of people over the age of 60 years, according to the American Academy of Ophthalmology. […] Entropion can cause irritation and damage the cornea. […] It can also lead to a corneal ulcer, which can become infected and lead to a severe loss of vision if a person does not receive prompt treatment. […] While a person is awaiting surgery, lubricating ointments and eye drops can help reduce irritation and the risk of damage.
#43 A study of the various etiologies and sequelae to ectropion and entropion. – Document – Gale OneFile: Health and Medicine
https://go.gale.com/ps/i.do?id=GALE%7CA687781839&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=25894528&p=HRCA&sw=w
The prevalence of ectropion and entropion put together was 0.064%. […] The senile cause is the highest (78.57%) among the etiologies of entropion. […] Eyelid malpositions have a low prevalence of 0.064%. […] The overall percentage of conjunctival and corneal complications was found to be significantly higher in ectropion than in entropion.
#44 Entropion – MD Searchlight
https://mdsearchlight.com/eye-health/entropion/
Entropion is a condition where the eyelid folds inward. […] Entropion is more likely to occur as people age and tends to affect women more than men. […] Lab tests are typically not needed to diagnose entropion. However, if the entropion is caused by scarring (cicatricial entropion), tests for infections or autoimmune diseases may be necessary before treatment is prescribed. […] The prognosis for Entropion can vary depending on the severity of the condition and the underlying cause. However, with proper treatment, most cases of Entropion can be managed effectively and complications can be minimized.
#45 Evaluation of outcomes of lower eyelid entropion and e…
https://ppch.pl/seo/article/01.3001.0053.9352/en
Entropion and ectropion of the lower eyelid are common causes of recurrent symptoms of eye globe surface irritation and decreased quality of life. […] Our study involved 100 patients treated with various surgical techniques and revealed a significant postoperative reduction in the severity of all symptoms evaluated subjectively according to the VAS scale as well as improvement in the somatic, psychological, and environmental domains of the WHOQOL-BREF questionnaire. […] Because there is no objective scale for the assessment of eyelid inversion, a new entropion grading scale (EnGS) was developed and used in this study. […] The modified Wheeler surgical technique implemented in our clinics contributed to the high percentage of very good functional and esthetic postoperative results. […] The results after entropion/ectropion surgery prove the effectiveness of the methods used. Complementing them with the Wh-m contributed to an increase in the number of very good outcomes. Significant improvement in eyelid and eye disorders in all patients, and in the physical, psychological, and environmental health of the prospective group were confirmed.
#46 Clinical epidemiological analysis of entropion in dogs and cats: retrospective study (2013-2020) in the veterinary hospital of the federal University of JataÃ | International Journal of Development Research (IJDR)
https://www.journalijdr.com/clinical-epidemiological-analysis-entropion-dogs-and-cats-retrospective-study-2013-2020-veterinary
Entropion is characterized by the inversion of the eyelid margin. […] Given the clinical importance of entropion, this study aimed to analyze the clinical and epidemiological aspects of this important disease in dogs and cats that were attended and surgically treated in the Veterinary Ophthalmology Department of the Veterinary Hospital of the Federal University of Jata in the period from 2013 to 2020. […] In the period, entropion corresponded to 6.2% of the total number of the casuistry in ophthalmic care. […] In this clinical epidemiological study, it was found that the most affected canine breeds are Shar-Pei and Chow Chow.
#47 Complicated entropion | Veterian Key
https://veteriankey.com/complicated-entropion/
Most cases of primary entropion are breed related, with an inherited component. It is not uncommon for several related animals to be affected with entropion and breeding from such individuals is to be discouraged. Unfortunately some breeders, particularly those of the Shar Pei, seem to consider it normal for puppies to require eyelid tacking at only a few weeks of age followed by sharp surgery when only a few months old. This attitude that the condition is not severe and easily managed by surgery with few long-term sequelae, such that it is not really important is a worrying trend among some breeders who deliberately choose animals with poor eyelid anatomy for breeding simply because that is the way they like the animals to look. Although the specific inherited factors contributing to entropion have not been identified, and a multifactorial aetiology is likely (as with hip dysplasia), the strong breed predisposition justifies advising against breeding from affected individuals and breed clubs should be encouraged to try to reduce the incidence of the condition in their particular breed.
#48 Eyelid: entropion in Cows (Bovis) | Vetlexicon
https://www.vetlexicon.com/bovis/ophthalmology/articles/eyelid-entropion/
Uni/bilateral inversion of lower eyelid margin. […] Geographic incidence: Worldwide. […] Epidemiology: Usually only an individual is affected but trends may be noticed in genetic lines.