Entropion

Overview

What is entropion?

Entropion happens when an eyelid turns inward towards the eye. This condition causes the eyelid skin and eyelashes to rub against the eyeball. That friction often causes discomfort and irritation of the cornea (front of the eye).

Entropion usually occurs in the lower eyelid. If it is not treated, it can damage the cornea and lead to vision loss.

How common is entropion?

Entropion is most common in people over 60 years old.

Symptoms and Causes

What causes entropion?

Lower eyelid looseness (laxity) or scarring usually causes entropion. This condition is common in older adults because the eyelid supports weaken with age allowing the eyelid muscles to turn the eyelids in. Other causes of an in-turned eyelid include an injury to the eye or having previous eye surgery.

What are the risk factors for entropion?

Aging is the biggest risk factor for entropion. People with a previous eye injury or surgery may develop entropion due to scar tissue on the eyelid.

What are the symptoms of entropion?

Entropion causes many uncomfortable symptoms in the eye. When the condition develops, symptoms may only occur occasionally. After time, the symptoms usually become constant. Signs of entropion include:

  • Feeling of something in the eye
  • Redness
  • Tearing (watering)
  • Blurry vision
  • Pain
  • Itching
  • Discharge

Diagnosis and Tests

How is entropion diagnosed?

A doctor diagnoses entropion by looking at the eye. Additional tests are not usually necessary.

Management and Treatment

How is entropion treated?

Entropion is treated in various ways—surgically and medically. Lubrication of the eye with ointment and artificial tears is important to help moisten the eye and relieve discomfort.

Tape can also be used to reposition the eyelid temporarily.

Surgery is usually performed to address the inward turning eyelid and return it to a normal position. These surgeries typically involve local anesthesia to numb the eyelid. Most people go home the same day as their surgery.

Alternatively, a small amount of a substance called botulinum toxin (Botox®) can be used to weaken the eyelid muscles that may be causing the lid to turn in. This may be used every three to four months if surgery is not an option.

Surgical procedures to treat entropion include:

  • Eyelid Tightening: This procedure shortens the eyelid (called a lateral tarsal strip) to tighten the lid.
  • Retractor reinsertion: This procedure is used to tighten the lid retractor (muscle that opens and closes the lid).

What complications are associated with entropion?

It is important to treat entropion to avoid complications that may become permanent. Complications associated with an inward-turning eyelid include:

Prevention

Can entropion be prevented?

Because entropion often occurs naturally with aging or after scarring, it is difficult to prevent. To reduce your risk of developing entropion caused by injury, wear protective eyewear during activities that could injure the eye.

Outlook / Prognosis

What is the prognosis (outlook) for people with entropion?

Most people who receive treatment for entropion before it damages the eye have a good prognosis. Surgery usually resolves the problem. People typically do not have discomfort after surgery. Entropion rarely returns after surgical treatment.

Living With

When should I call the doctor?

Contact your doctor if your eyelid turns inward. Even if the eyelid does not appear to turn inward, seek medical treatment if you feel like something is constantly in your eye.

What questions should I ask my doctor?

If you have entropion, you may want to ask your doctor:

  • What complications should I look out for?
  • Is there anything I should avoid during recovery?
  • Do I need a follow-up visit and if so, when?

When can I go back to my regular activities?

People treated surgically for entropion can usually return to all of their normal activities a few weeks after the operation.

Last reviewed by a Cleveland Clinic medical professional on 07/31/2018.

References

  • American Academy of Ophthalmology. Diagnosis and Management of Involutional Entropion. (https://www.aao.org/eyenet/article/diagnosis-management-of-involutional-entropion) Accessed 7/5/2018.
  • American Society of Ophthalmic Plastic & Reconstructive Surgery. In-turned Eyelid (Entropion). (https://www.asoprs.org/entropion) Accessed 7/5/2018.
  • Merck Manual. Entropion and Ectropion. (https://www.merckmanuals.com/home/eye-disorders/eyelid-and-tearing-disorders/entropion-and-ectropion) Accessed 7/5/2018.
  • National Health Service. Entropion. (http://www.uhs.nhs.uk/Media/Controlleddocuments/Patientinformation/Eyes/Entropion-patientinformation.pdf) Accessed 7/5/2018.

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