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March 1966

Surgical Management of Orbital Tarsal Disparity

Author Affiliations

Springfield, Mass
Dr. Bick is in private practice in Springfield.

Arch Ophthalmol. 1966;75(3):386-389. doi:10.1001/archopht.1966.00970050388015

The purpose of this paper is to describe a simple procedure for the correction of both senile ectropion and entropion and to clarify the history of operations at the outer canthus.

Orbital tarsal disparity is the concept that there is inadequate pressure between the orbital contents and the lid. Whatever reduces orbital contents or relaxes the lid structure results in orbital tarsal disparity. The clinical manifestations, either ectropion or entropion, are familiar to ophthalmologists.

It is possible to inject 2 to 4 cc of physiological saline into the muscle cone and obtain immediate though temporary disappearance of either ectropion or entropion.

Since it is impractical to increase the orbital contents permanently, it is much simpler to shorten the lid. At first I was under the impression that it was necessary to perform one kind of procedure for ectropion and another for entropion. Later experience proved that only one procedure was

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