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Case Reports
. 2022 Jan 29:25:101371.
doi: 10.1016/j.ajoc.2022.101371. eCollection 2022 Mar.

Neonatal corneal ulcer secondary to congenital entropion

Travis K Redd  1   2 , Robert C Kersten  1 , Davin Ashraf  1 , Lauren Hennein  1 , Gerami D Seitzman  1   2
Affiliations
Case Reports

Neonatal corneal ulcer secondary to congenital entropion

Travis K Redd et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: To describe a case of central corneal ulceration in a newborn secondary to congenital entropion.

Observations: Corneal ulcers during infancy are rare and may occur secondary to congenital structural anomalies, including congenital entropion. Correct anatomic eyelid position in newborns is challenging to determine with closed eyelids, and eyelid squeezing during crying and discomfort adds to this challenge.

Conclusions and importance: This report reinforces the importance of careful examination of the adnexa in infants with corneal ulcers while they are most comfortable, usually after topical anesthesia and prior to placement of eyelid speculum. Ophthalmologists caring for infants must be able to detect this condition because prompt entropion repair is necessary for corneal ulcer resolution and prevention of permanent vision loss.

Keywords: Congenital entropion; Infectious keratitis; Pediatric corneal ulcer.

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Conflict of interest statement

The following authors have no financial disclosures: TR, RK, DA, LH, GS.

Figures

Fig. 1
Fig. 1
Serial photography of an infant with congenital entropion and corneal ulcer. At presentation this 3-week-old girl demonstrated an inferior peripheral corneal ulcer in the right eye (a). Frequent application of broad spectrum topical antibiotic therapy resulted in clearing of the stromal infiltrate, but no change in the epithelial defect after two weeks (b). At a subsequent visit entropion of the right lower eyelid was identified (c) after instillation of topical proparacaine. Botulinum toxin was administered to the pretarsal orbicularis muscle, with resolution of entropion (d) and improvement of the corneal epithelial defect (e) after one week. Five months after botulinum toxin injection (f) the eyelid remains in excellent position and the cornea is clear.
See this image and copyright information in PMC

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