PATIENT: A 87yo Black man was referred for trichiasis and possible electrolysis of his left lower lid.

SYPMTOMS: The patient complained of excessive tearing, mucous discharge, matting, crusting, redness, and foreign body sensation for the past 3 years.

HISTORY: Patient’s ocular history for positive for cataract surgery OU 8 years prior and metallic foreign body removal OD 10 years ago. His medical history consisted of CVD, HTN, and COPD.

TESTING: BCVA was 20/30 OD and 20/25 OS. Preliminary testing were unremarkable. Biomicroscopy of the anterior segment of the right eye revealed a moderate nasal pterygium and 3mm mid-peripheral corneal scar. The left eye showed severe lower lid entropion and secondary trichiasis with lashes rubbing on the inferior cornea. The lashes of the superior and inferior lids had mucous discharge and crusting at the tips. Involutional laxity of the lower eyelids were evident OS>OD, making it easier to “roll” inward.

Dx and Mx: The patient was diagnosed with primary entropion LLL and secondary trichiasis. The plan was to surgically repair the lower lid with a lateral tarsal strip procedure in order to improve the apposition of the lower eyelid to the globe. The procedure is performed in office and lateral sutures are treated with abx ointment for 2-3 weeks post-op. Typically sutures will fall and/or dissolve after 2 weeks.