Management and Referral

1. Trichiasis - epilate (pull out) the offending lashes with forceps.

2. Entropion - use Steristrips or Sellotape as a temporary measure to pull the lower lid off the globe - to do this (Fig. 2.30):

■ place one end of a Steristrip on the skin just below the lashes

■ pull down gently until lashes are pulled off the globe

■ stick other end onto cheek

■ use three Steristrips in a row.

3. Stain the cornea with dilute fluorescein and look for lash-induced abrasions.

Fig. 8.9 Entropion -the lid is turned towards the eye - the lashes are in contact with the ocular surface - can occur in both the lower and upper lid

4. If corneal staining is present prescribe chloramphenicol ointment 1% three times daily for 5 days.

5. Refer to ophthalmologist for definitive surgery.

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