There has been no published investigation into the reasons why some patients with severe trachomatous conjunctival scarring develop entropion and trichiasis while others do not. In a population of leprosy patients with severe trachomatous conjunctival scarring the authors found that lagophthalmos correlated with the absence of trichiasis and entropion. We suggest that orbicularis oculi muscle function, as well as other anatomical variations among individuals, may contribute to the development of trachomatous entropion and trichiasis in patients with conjunctival scarring.
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