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Lower eyelid entropion in thyroid eye disease
Varshitha Hemanth Vasanthapuram1, Milind N Naik1
1Ophthalmic Plastic Surgery Service, L.V. Prasad Eye Institute, Hyderabad, India.
Orbit (Amsterdam, Netherlands)
|March 29, 2021
Summary
Lower eyelid entropion is a rare sign of thyroid eye disease (TED). Surgical release of lower eyelid retractors can effectively correct this condition, especially when associated with proptosis.
Area of Science:
- Ophthalmology
- Endocrinology
Background:
- Thyroid eye disease (TED) is an autoimmune condition affecting the orbit.
- Lower eyelid entropion is an uncommon manifestation of TED.
Purpose of the Study:
- To describe the clinical and ultrasound biomicroscopy (UBM) features of lower eyelid entropion in TED patients.
- To evaluate management outcomes for this rare presentation.
Main Methods:
- Retrospective review of patients with TED and lower eyelid entropion over 12 years.
- Clinical assessment, Hertel exophthalmometry, and UBM were utilized.
Main Results:
- Five patients (0.41%) presented with lower eyelid entropion.
- Common findings included upper and lower eyelid retraction, and corneal epitheliopathy.
- UBM revealed a thickened middle lamella; surgical release of lower eyelid retractors corrected entropion in two patients.
Conclusions:
- Lower eyelid entropion is a rare but significant sign in TED.
- A multifactorial mechanism involving thickened lower lid retractors is suggested.
- Orbital decompression with lower eyelid retractor release is an effective treatment.
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