Cicatricial entropion (inward rotation of eyelid due to scarring) differs from involutional (senile) entropion in that cicatricial entropion:

• A Is caused by horizontal lid laxity and preseptal orbicularis override
• B Is treated primarily by everting sutures (Snellen/Quickert sutures)
• C Results from shortening of the posterior (conjunctival/tarsal) lamella causing inward rotation ✓
• D Is most common in the lower lid of elderly patients bilaterally

Explanation

Cicatricial entropion results from scarring and shortening of the POSTERIOR lamella (conjunctiva and tarsus) pulling the eyelid margin inward. Causes include trachoma, Stevens-Johnson syndrome, chemical burns, and pemphigoid. Treatment requires posterior lamellar lengthening (e.g., mucous membrane grafting). Involutional entropion, in contrast, results from horizontal lid laxity, dehiscence of lower lid retractors, and overriding of the preseptal orbicularis — treated with everting sutures, lid tightening, or Jones' procedure. Involutional entropion is indeed the most common type in elderly patients.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.