Abstract:
PURPOSE:To describe the manual provocation test (MPT), a novel test for intermittent involutional entropion of the lower eyelid. METHODS:Retrospective review of patients with intermittent entropion who presented with ocular irritation and documented inward eyelid rotation by them or their referring physicians, but who had no apparent entropion at the time of initial consultation. Results of the MPT were recorded for this group, and then evaluated prospectively in an age-matched comparison group of patients presenting for blepharoplasty who had no history of entropion. The essential steps of the MPT are as follows. Step 1: the lower eyelid skin is grasped below the inferior border of the tarsal plate. Step 2: the lid is drawn anteriorly as with the eyelid distraction test. Step 3: the patient is directed to forcefully close the eyelids. Step 4: the eyelid is released and the result is observed for manifest entropion. RESULTS:Thirteen eyelids in 12 patients with intermittent involutional lower eyelid entropion were included in this study. Average patient age was 77.3 years (±9.5 SD). The MPT elicited entropion in all 13 eyelids. Of the 12 patients, 9 elected to pursue surgery and, of these patients, all eyelids were successfully treated with subsequent improvement of symptoms. The MPT was thereafter negative in these patients. None of the 20 patients in the blepharoplasty comparison group (average age 71.6 years) demonstrated a positive MPT. CONCLUSIONS:The MPT can be a valuable and straightforward test in the clinical evaluation of patients with a history of intermittent entropion.
journal_name
Corneajournal_title
Corneaauthors
Tonk RS,Meyer DRdoi
10.1097/ICO.0000000000000762subject
Has Abstractpub_date
2016-04-01 00:00:00pages
510-2issue
4eissn
0277-3740issn
1536-4798journal_volume
35pub_type
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