Entropion occurs when the lower eyelid turns inward, rubbing against the eye surface and causing irritation, pain, watering, infection, and vision loss. It is more common among older adults.
Entropion can be caused by various factors, such as:
Muscle weakness. As people age, the muscles under the eyes tend to weaken and the tendons stretch out. This can make the eyelid sag and roll inward.
Scars or previous surgeries. Skin that is scarred by chemical burns, trauma, or surgery can distort the normal curve of the eyelid and pull it inward.
Eye infection. An eye infection called trachoma, which is prevalent in some developing countries, can cause scarring of the inner eyelid and lead to entropion and blindness.
Inflammation. An irritation of the eye caused by dryness or inflammation can make people rub or squeeze their eyelids, which can trigger a spasm of the eyelid muscles and cause the eyelid to turn inward.
Developmental complication. Some people are born with entropion due to an extra fold of skin on the eyelid that causes the eyelashes to turn inward.
The main symptoms of entropion are:
The feeling that something is in the eye
Eye redness
Eye irritation or pain
Sensitivity to light and wind
Watery eyes (excessive tearing)
Mucous discharge and eyelid crusting
If left untreated, entropion can cause damage to the transparent covering of the eye (cornea), eye infections, and vision loss.
An eye exam and physical can usually diagnose entropion. In addition to pulling on the eyelids, the doctor may ask the patient to blink or close the eyes forcefully. By assessing the position, muscle tone, tightness, and cause of entropion, the doctor can diagnose the condition.
The treatment of entropion depends on the cause and severity of the condition. Some nonsurgical treatments are available to relieve symptoms and protect the eye from damage, such as:
Soft contact lens. A type of soft contact lens can be used as a corneal bandage to help ease symptoms. These are available with or without a prescription.
Botox. Small amounts of Botox can be injected into the lower eyelid to turn the eyelid out. The effects can last up to six months.
Stitches that turn the eyelid outward. This procedure can be performed in the doctor's office under local anesthesia. Several stitches are placed along the affected eyelid to turn it outward. The stitches are removed after a few weeks. After several months, the eyelid may turn inward again, so this is not a long-term solution.
Skin tape. Special transparent skin tape can be applied to the eyelid to keep it from turning in.
In most cases, surgery is required to fully correct entropion, especially if it is caused by muscle weakness or scarring. Some common types of surgery include:
If entropion is caused by muscle weakness, the surgeon can remove a small part of the lower eyelid to tighten the affected muscles and tendons. The surgeon can also reposition the eyelid margin to prevent it from rolling inward.
If the entropion is caused by scar tissue, previous surgery, or other conditions, the surgeon will perform a mucous membrane graft from the roof of the mouth or nasal passages. The graft is used to replace the scarred tissue and restore the normal curve of the eyelid.
Surgery is usually done with local anesthesia and sedation. After surgery, the patient may need to use antibiotic ointment, eye drops, and cold compresses to help with healing and prevent infection.
Entropion may not be preventable in some cases, such as those caused by aging, genetics, or trauma. However, some steps can be taken to reduce the risk of developing or worsening entropion, such as:
Avoiding rubbing or squeezing the eyes
Treating any eye infections or inflammations promptly
Using artificial tears and lubricating ointments to keep the eyes moist
Wearing sunglasses and protective eyewear to shield the eyes from wind, dust, and sun
Seeking medical attention if any signs or symptoms of entropion occur
The condition of entropion can affect the quality of life and vision of the affected person. It is important to seek diagnosis and treatment as soon as possible in order to prevent complications and maintain eye health.
