Eyelid ectropion caused by glasses. Mechanical centurion syndrome.

CASE REPORT: A 73 year-old woman with epiphora and ocular irritation resistant to medical treatment. The lacrimal pathway was permeable and there was no eyelid malposition. On examining the patient with her glasses on, both lower eyelids presented an inner third ectropion. Once the diagnosis was established and the mechanical factor resolved, the clinical symptoms improved within a few days. DISCUSSION: The diagnosis of the eyelid ectropion can be more complex when the ectropion is secondary to wearing glasses. The presence of the epicanthic fold shows the importance of the mechanical factor. In our patient the characteristics of the ectropion were similar to the so-called centurion syndrome.

Surgical repair of paralytic lagophthalmos by medial tarsal suspension of the lower lid.

BACKGROUND: The seventh nerve palsy causes loss of function in the affected orbicularis oculi muscle. There is exposure and dessication of the corneal surface and obvious aesthetic changes in facial symmetry. METHOD: A surgical procedure has been used in 11 patients to substantially improve palpebral closure. The technique consists of a small upper lid tarsoconjunctival flap sutured into a nasal pretarsal pocket of the lower lid, achieving a medial tarsal suspension of the lower lid. RESULTS: This technique improves cosmesis, is reversible, and combinable with other procedures. The signs and symptoms of exposure keratitis are satisfactorily resolved. There have been no complications in an average follow up of 5 1/2 years after this surgical procedure. CONCLUSION: This technique could be considered an appropriate treatment for patients suffering temporary or permanent facial palsy.