ZyraDoc #31 - September 01, 2026

An 82-year-old woman presents with severe pain, foreign body sensation, and persistent tearing in her left eye.

Slit-lamp examination reveals that her left lower eyelid margin is completely turned inward, causing her eyelashes to rub directly against the ocular surface.

Fluorescein staining demonstrates a large, linear vertical epithelial defect across the inferior third of the cornea.

Case Summary

Clinical Focus:

An 82-year-old female presents with severe involutional entropion of the left lower eyelid complicated by prominent trichiasis and an acute secondary corneal epithelial abrasion.

Diagnostic criteria for entropion include:

Inward rotation or inversion of the lid margin and eyelashes toward the globe
Persistent mechanical trauma caused by inverted lashes rubbing aggressively on the cornea (trichiasis)
Pathophysiology driven primarily by age-related degeneration or weak orbicularis oculi muscle configurations
Secondary structural damage to the ocular surface, including dense superficial punctate keratitis or frank corneal ulceration

While short-term non-invasive structural measures can provide rapid, immediate stabilization for the cornea, definitive cure of advanced involutional or cicatricial variants requires mechanical surgical reconstruction.

Here is the Management Strategy:

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