ENTROPION
entropion
A defect of the
eyelids
in w hich the
edges of the lids turn inwards, causing
the lashes to rub against the
cornea
(the
transparent dome that forms the front
of the eyeball) and the
conjunctiva
(the
membrane that covers the white
of
the eye and the inside of the eyelid).
CAUSES
Entropion may be congenital (present
from birth), especially in overweight
babies. In addition, it is common in
elderly people, due to weakness of the
muscles around the lower eye, allowing
the lower lid plate to turn inwards.
Entropion of the upper or lower lid may
also be caused by scarring, such as that
due to
trachoma
.
COMPLICATIONS AND
OUTLOOK
Entropion in babies does not disturb the
eye and usually disappears w ithin a few
months. In later life,
entropion
can
cause irritation,
conjunctivitis
,
damage to
the cornea, or problems with vision.
Surgery to correct entropion can pre-
vent such conditions.
ENT surgery
The
abbreviation for
ear,
nose,
and
throat surgery (see
otorhinolaryngology
) .
enucleate
To remove an
organ,
a tumour,
or
another structure surgically in such a
way that
it
comes
out
cleanly
and
completely. A common example of enu-
cleation is the removal of an eyeball
while leaving the other structures in
place in the eye socket.
enuresis, nocturnal
The medical term for bedwetting. It is a
common condition in children, and
boys are slightly more likely than girls
to be affected. The problem tends to
run in families.
CAUSES
Usually,
enuresis
results
from
slow
maturation of nervous system func-
tions concerned with bladder control.
It may also result from psychological
stress. In a small number of bedwetters,
there is a physical cause, such as a
structural abnormality of the
urinary
tract
.
Diabetes mellitus
or a
urinary tract
infection
may cause bedwetting in a
child w ho was previously dry. In cases
due to physical problems, the child also
has
difficulty with
daytime
bladder
control (see
incontinence, urinary
) .
INVESTIGATION
AND
TREATMENT
If a child wets the bed persistently, tests,
including
urinalysis
,
may be performed
to rule out a physical cause. For bedwet-
ting that is not caused by a physical
disorder, treatment starts with training
the child to pass urine regularly during
the day. Systems such as rewarding the
child for each dry night (for example,
by putting stars on a chart) are often
successful. Getting the child to go to the
toilet just before bed may be helpful.
Punishing a child for bedwetting, how-
ever, w ill not help, and may actually
worsen the problem by making the
child anxious.
Alarm systems, known as buzzer and
pad systems, that involve placing
a
humidity-sensitive pad in the child’s
bed are available. The child is woken
by the alarm if urine is passed and
eventually learns to wake before start-
ing to pass urine.
The drug desmopressin is a synthetic
form of antidiuretic hormone (see
ADH
)
that may occasionally be given to redu-
ce the amount of water that is excreted
by the kidneys. Desmopressin is useful
on the occasional nights when a child
needs to stay dry, such as when staying
overnight with friends.
environmental medicine
The study of the effects on health of
natural environmental factors, such as
climate, altitude, sunlight, and the pres-
ence of various minerals. Environmental
medicine overlaps somewhat with
occu-
pational medicine
,
in w hich the effects
on people of their working environ-
ments are studied.
CLIMATE
The
symptoms
of
particular
types
of illness may be affected by certain
climates. For example, sufferers from
chest disorders, such as chronic
bronchi-
tis
and
asthma
,
usually obtain some
relief from their symptoms in a warm,
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