title: Involutional entropion and ectropion of the lower eyelid: prevalence and associated risk factors in the elderly population.
abstract: OBJECTIVE
  To determine the prevalence of involutional entropion and ectropion of the lower eyelid in the elderly population; to examine how these disorders are related to gender, age, skin color, and axial ocular globe projection; and to define the incidence of associated ocular surface and pathologic eyelid findings.
  
  
  METHODS
  An ophthalmic survey was conducted in 24,565 elderly people. All participants underwent ophthalmic examination by general ophthalmologists to identify entropion and ectropion. Information about associated ocular surface and pathologic eyelid findings were collected from all patients with involutional eyelid malposition. Patients with involutional entropion and ectropion underwent measurements of the axial ocular globe projection. The Pearson chi-square test and the Mann-Whitney U test were performed.
  
  
  RESULTS
  The prevalence of involutional entropion was 2.1%; 1.9% in men and 2.4% in women. The prevalence of involutional ectropion was 2.9%; 5.1% in men and 1.5% in women. Dry eye syndrome, lower retractor laxity, and superficial punctate keratopathy were seen significantly more often in patients with involutional entropion than in those with involutional ectropion (p < 0.001). Chronic conjunctivitis was significantly more common in patients with involutional ectropion than in those with involutional entropion (p < 0.001). The axial ocular globe projection was significantly smaller in patients with involutional entropion than in those with involutional ectropion (p < 0.001).
  
  
  CONCLUSIONS
  The prevalence of involutional entropion and ectropion in the elderly population is 2.1% and 2.9%, respectively. The axial ocular globe position plays a pathogenic role in involutional lower eyelid malposition.
authors.affiliation: Department of Ophthalmology and Vision Institute, Federal University of São Paulo, Brazil. renato.damasceno@unifesp.br
authors.forename: Renato Wendell
authors.initials: RW
authors.lastname: Damasceno
authors.forename: Midori Hentona
authors.initials: MH
authors.lastname: Osaki
authors.forename: Paulo Elias Correa
authors.initials: PE
authors.lastname: Dantas
authors.forename: Rubens
authors.initials: R
authors.lastname: Belfort
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004483:Ectropion / Q000453:epidemiology*; D004774:Entropion / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors