EntropionTutorial - A Practical Approach

A basic tutorial on a practical approach to entropion from Mr Richard Caesar and oculoplastics.info

[@asaddar5274]

A great teacher as always,following Ric for 08 years nice change still fan of his videos,want to learn heamostasis during his procedures

[@aapt9887]

Thank you so much! In my hospital we also remove part of the orbicularis muscle that's on the tarsus so we can avoid the orbicularis pushing the eyelid towards the globe. Sometimes we don't even touch the retractors. Really enjoyed the step by step approach on this video going from simple plication to more radical solutions. Thank you!

[@zomorrorod7]

Hello Doctor Ric Caeser, What is the best surgery for distichiasis that involves the whole length of the lid margin? Thank you for teaching us 😊

[@riccaesar]

Hi Zomorrorod, great question. Distichiasis is very difficult to treat. In the upper lid a full tarsal rotation can be effective, but often regresses even when done dramatically. In the lower lid I've excised and advanced the posterior lamella but again with regression. Electrolysis is an ongoing game but has a place. Bandage contact lens and skilled self epilation with a magnifying mirror can be useful but is lifelong and dull for the patient. The problem is that when you have metaplastic change in the meibomian glands such that they produce lashes removing or destroying the glands still results in severe oil deficiency. I don't have any universal solution but try to take into account where the patient is willing to compromise. If you find a brilliant technique please let me know! Best wishes Ric

[@zomorrorod7]

@@riccaesar Thanks so much Dr Ric Caeser, What about excision of a strip of the marginal tarsus to remove the distichiatic lashes then suture mucous membrane graft? Will postoperative entropion or lid deformity be an issue? The other option is splitting the anterior and posterior lamellae with applying cryotherapy? I have a case with lid margin keratinization and metaplastic lashes, very large number of distichiatic lashes.

[@riccaesar]

@@zomorrorod7 Hi. Both techniques are worth trying but both can be associated with subsequent cicatricial entropion. Lid split and cryo is probably the safer option to try first. Best wishes Ric

[@aymendaldoul380]

Great video as usual! Thank you so much for your effort professor

[@ФаридаЖуагельдиева]

Very useful channel I have ever seen!😍

[@uk-sr4uo]

Thanks Sir for the informative video . What are the modalities for an overcorrection

[@riccaesar]

Hi. It's difficult to overcorrect so long as you have fully tightened the lower lid horizontally. With residual lid laxity, you can induce an ectropion. In this instance the best repair is to tighten the lax lid. If you over tighten the lower lid retractors and effectively shorten the vertical height of the lower lid - (pull it down), then you'd have to go back and release your sutures. I'm sure this is possible, but I've not seen it! Best wishes. Ric

[@brookerenee3683]

I got a question the corner of my eye is always itchy and my doctors can’t figure out why or they say it’s allergies but we’ve been using her allergy drops and medicine nothings working. What do you think it is since you’re a doctor I figured you know you could help me a little.

[@riccaesar]

Hi, itchy eye is either something physical irritating like an ingrowing eyelash, or chemical irritation from haircare or skincare, or foreign airborne protein from plant or animal. If nothing is working so far, you need to go back to the beginning, see another ophthalmologist and let them take another look. I'm optimistic you'll find a treatable cause and resolve that itch! Best wishes Ric

[@moimeme1512]

Thanks for the great courses ! It would be great if you could make a course about regional blocks and how to perform them ! In addition, a course about lid reconstruction after cancer surgery would also be amazing. Thanks again for your videos, it's extremely valuable when performing these surgeries for the first times !

[@marcoantonini9039]

Dear mr Ric Caesar. You are tremendously talmented both as surgeon and as instructor, and MOST of all as a movie maker! Would be possibile to Shadow you for a while?

[@riccaesar]

Hi Marco. I've had the pleasure of a number of observers over the years. It has always been fun, and Cheltenham and the Cotswolds are a beautiful area to visit. Please contact me via my NHS secretary. I'm based at Cheltenham General Hospital. UK. Best wishes.

[@titorbay]

Excellent teacher

[@dikraalbatal5699]

very nice lecture but please whish best type of stitch can used for lower eye lid entropion

[@riccaesar]

Hi Dikra. I like a 5.0 vicryl for my everting suture / retractor plication suture. I still prefer 5.0 prolene for my LTS, but can also use vicryl. For standard lid closure I use 6.0 vicryl. Best wishes Ric

[@hasanelzend8052]

Thanks so much indeed 👍 prof

[@plasticsurgery1971]

Fantastic talk!

[@joannam6140]

Excellent lecture!

[@riccaesar]

Thanks! You are most welcome. Please download, distribute and share as you see fit. Ric

[@Iryzz]

Great, very well explained. Thanks!

[@riccaesar]

Hi Irene. You are very welcome. Please feel free to download and copy and use in tutorials. Best wishes. Ric

[@Iryzz]

@@riccaesar I absolutely love your tutorials. Are there any oculoplastics fellowships available in the hospital where you work? Or is there a way to assist or attend your surgeries? Thank you!

[@riccaesar]

@@Iryzz Hi Irene. Our fellowships stopped with Covid and haven't yet restarted properly. I do have observers from time to time and you would be most welcome. Please email me via my website details with proposed dates. Best wishes. Ric

[@Iryzz]

@@riccaesar Hello M. Caeser. Thank you for your answer. I have tried to write to you via your contact form on your website but it doesnt allow me to send the message as an "error" message pops up! Is there another way I can contact you?

[@Iryzz]

Hello Dr Caesar, I have tried to reach out to you via your website and I had an email exchange with Tina, I hope you received my emails. I can actually come as an observer in September/October if you are available in that period. How can I contact you personally in order to check for the dates? Thank you and looking forward to hearing from you soon! Irene

[@QatarRC]

Hello Doctor.. can i contact with you on the phone ?

[@BihariBabuaaaa]

My Mother is facing this problem since few years now. 3 entropion surgeries done, but no relief. can you give me doctors details who are expert in these kind of surgeries

[@uk-sr4uo]

How is it now? What's your location?

[@LearnQuran820]

😘😘😘😘

[@ammar525]

Overriding of orbicularis