title: Upper eyelid entropion and dry eye in cicatricial trachoma without trichiasis.
abstract: OBJECTIVE
  to evaluate the position of the upper eyelid margin and eye surface status in cicatricial trachoma without trichiasis (TS).
  
  
  METHODS
  Slit-lamp biomicroscopy was employed to evaluate the location of the upper lid mucocutaneous transition of 156 eyes of 78 patients with trichiasis and of 130 eyes of 65 control subjects. For each eye the position of the upper lid mucocutaneous junction was graded with respect to the line of meibomian gland orifices into 3 categories: a) anterior, b) at the line, and c) posterior to the line. Ocular surface dye staining with lissamine green was performed in all eyes. All participants answered a questionnaire with queries on the presence and intensity of dry eye symptoms.
  
  
  RESULTS
  In the eyes with trichiasis the location of the mucocutaneous transition was posterior to the meibomian gland line in 55 (35.3%), at the line in 77 (49.4%) and anterior to the line in only 24 (15.4%). In the control group these figures were: 5 (3.8%); 42 (42%) and 83 (63.8%). Lissamine staining and dry eye symptoms were also associated with trichiasis.
  
  
  CONCLUSIONS
  Different degrees of upper lid entropion are already present in cicatricial trachoma even in the absence of trichiasis. Trichiasis is associated with lissamine green staining and dry eye symptoms. Conjunctivalization of the upper lid margin may play a role in the development of trachomatous dry eye.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - USP, Ribeirão Preto, SP, Brazil.
authors.forename: Abrahão
authors.initials: A
authors.lastname: Lucena
authors.forename: Patricia Mitiko Santello
authors.initials: PM
authors.lastname: Akaishi
authors.forename: Maria de Lourdes Veronesi
authors.initials: Mde L
authors.lastname: Rodrigues
authors.forename: Antonio Augusto Velasco e
authors.initials: AA
authors.lastname: Cruz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004396:Coloring Agents; D015352:Dry Eye Syndromes / Q000473:pathology*; D004774:Entropion / Q000473:pathology*; D005143:Eyelids / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D013194:Staining and Labeling / Q000379:methods; D011795:Surveys and Questionnaires; D014141:Trachoma / Q000473:pathology*; D058457:Trichiasis
chemical_list: D004396:Coloring Agents