An entropion occurs where the eyelid turns towards the eye. The eyelashes then rub against the front of the eye (cornea). Irritation, pain and watering of the eye are the main symptoms. Taping the eyelid to the cheek, lubricant eye ointment and sometimes botulinum toxin injections help to control symptoms. People often require surgery if the problem persists.
Entropion and trichiasis
An entropion occurs where an eyelid turns inwards towards the eye. This causes the eyelashes to rub against the front of the eye (the cornea). Trichiasis is the medical term used to describe the eyelashes turning in against the front of the eye. The lower eyelid is most commonly affected.
What are the symptoms of an entropion?
- Irritation and pain on the front of the eye.
- A watery eye.
- If left untreated, the front of the eye (the cornea) may become damaged (a corneal ulcer may develop). The cornea is vital for vision and a damaged cornea may affect eyesight.
In the UK, entropion mainly occurs in older people, associated with weakness of the small muscles around the eyelid.
The main cause worldwide is due to trachoma. This is a common infection in tropical countries, which affects the front of the eye. This can lead to scarring and disruption to the eyelid, which makes it turn inwards.
Less common causes include other eye infections or damage. Rarely, people can be born with a defect that causes the eyelid to turn inwards.
If the cause is likely to be temporary, such as an infection or minor injury, the following may be enough until the condition recovers:
- Taping the eyelid to the cheek; or
- Injecting the muscles of the eyelid with botulinum toxin.
Lubricating eye ointment is often prescribed in the meantime to protect the front of the eye (cornea).
What is entropion repair surgery?
If you have a condition which is unlikely to recover by itself, you will be offered surgery. A small operation is performed to turn the eyelid back to its normal position. This stops the eyelashes from rubbing on the eye. The operation is usually successful and prevents any further damage to the front of the eye.
Further reading and references
Bergstrom R, Czyz CN; Eyelid Reconstruction, Entropion. StatPearls Publishing 2017 Dec 3.
Boboridis KG, Bunce C; Interventions for involutional lower lid entropion. Cochrane Database Syst Rev. 2011 Dec 7(12):CD002221. doi: 10.1002/14651858.CD002221.pub2.
Deka A, Saikia SP; Botulinum toxin for lower lid entropion correction. Orbit. 2011 Jan30(1):40-2.
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