INFANTILE ULCERATIVE KERATITIS SECONDARY TO CONGENITAL ENTROPION

Congenital entropion is a rare eyelid anomaly that can cause chronic c orneal erosions or ulceration. The diagnosis may be easily overlooked by both the pediatrician and the ophthalmologist, particularly when th e lids are tightly closed in the crying child. We present three cases of congenital entropion associated with corneal ulceration. Each patie nt underwent a complete ophthalmologic examination. Examination under anesthesia, including corneal scrapings for culture and photography, w as performed before surgical repair of the entropion. There were two c ases of lower lid entropion and one case of upper lid entropion. In al l three cases symptoms were present since birth, and the diagnosis was overlooked by the treating pediatrician. Corneal ulceration ultimatel y developed in all three cases. Cultures revealed Staphylococcus aureu s in one case, and coagulase negative Staphylococcus in another case. Cultures were negative in one case. In all three patients the ulcers h ealed rapidly after surgical entropion repair. Congenital upper or low er lid entropion is an uncommon condition that does not spontaneously improve and is an important cause of corneal ulceration in infants. Re cognition of this condition is often difficult, and early surgical int ervention to repair the lid deformity may help to avoid permanent corn eal scarring and visual loss.