Recently, 5-year-old Xiao Hong visited Fuzhou Aier Eye Hospital with persistent eye discomfort and unexplained tearing. After examination by Liu Jian, Director of our Lacrimal, Orbital, and Oculoplastic Surgery Department, he was diagnosed with "bilateral entropion and trichiasis, bilateral congenital epicanthal folds."
Director Liu Jian advises that while infantile entropion cannot be prevented, parents should not overlook symptoms like eye discomfort, tearing, or a foreign body sensation. Promptly seek an eye examination for your child.
Unexplained Tearing and "Inward-Growing" Eyelashes
According to Xiao Hong's parents, the child had experienced unexplained tearing for four years without serious concern. Recently, however, the tearing worsened and began interfering with schoolwork, prompting them to seek medical attention.After a detailed consultation and examination by Liu Jian, Director of the Lacrimal and Orbital Plastic Surgery Department, it was determined that Xiao Hong suffered from "bilateral lower eyelid entropion with trichiasis and bilateral congenital epicanthal folds."
Director Liu explained that Xiao Hong's condition represents congenital entropion, commonly seen in infants and young children. It is typically caused by epicanthal folds, overdevelopment of the orbicularis oculi muscle at the eyelid margin, or underdevelopment of the tarsal plate.
It is understood that congenital entropion and trichiasis typically present with symptoms such as photophobia, tearing, foreign body sensation, stinging, and friction.Severe entropion can cause long-term corneal damage through persistent irritation. Similarly, inverted eyelashes rubbing against the eyeball may lead to conjunctival hyperemia, superficial corneal opacity, neovascularization, corneal epithelial keratinization, and corneal ulcers.Therefore, Director Liu Jian recommended surgical correction for Xiao Hong to address his lower eyelid entropion, trichiasis, and bilateral congenital epicanthal folds.▲Xiao Hong's bilateral lower eyelid entropion and trichiasis
Refusing Red Envelopes Demonstrates Medical Ethics; Thoughtful Return Warms Hearts
Initially, Xiao Hong's parents worried surgery might affect their child's eye appearance. "Is surgery necessary? Are there alternatives? Could we just 'curl' or 'pluck' the inverted lashes?"
In response, Dr. Liu Jian explained that while trichiasis can be treated by plucking the inverted lashes, this is merely a temporary fix. Even if the inverted lashes are removed, the hair follicles will continue to grow new ones, which may be thicker and stiffer. This increased friction and irritation against the cornea heightens the risk of corneal scratches and damage. Severe cases can lead to vision loss or even blindness.Given the child's young age, early surgery is more conducive to recovery.
Addressing the parents' concerns about cosmetic outcomes, Director Liu explained that during surgery, doctors would perform entropion correction aligned with the child's natural eyelid skin texture to properly resolve eyelid function issues. With ideal postoperative recovery, any differences would be barely noticeable without close inspection.
▲Director Liu Jian addressing Xiao Hong's parents' concerns
Eager for a successful surgery, Xiao Hong's parents offered Director Liu Jian a red envelope. After repeated refusals, he pretended to accept it to reassure them and proceed with the procedure.
After alleviating the parents' concerns, Director Liu performed bilateral lower eyelid entropion correction combined with epicanthoplasty on Xiao Hong. The procedure proceeded smoothly. Postoperatively, Director Liu stated, "Healing the sick is a doctor's duty. I appreciate the sentiment, but I cannot accept the money."He immediately handed the red envelope to the head nurse, instructing her to return the money to the patient's medical account. ▲Pre- and post-operative comparison photos of Xiao Hong To express their gratitude, the patient's family delivered a commemorative banner the next day. Embroidered with the words "Exemplary in both medical ethics and skill, compassionate in heart and practice," it conveyed their heartfelt thanks to Director Liu Jian.