Entropion

Overview

What is entropion?

Entropion happens when your eyelid turns inward toward your eyeball. This condition causes your eyelid skin and eyelashes to rub against your eye. The friction often causes discomfort and irritation to your cornea (front of your eye).

Entropion usually occurs in your lower eyelid, and it can occur on one side or both (bilateral entropion). If it’s not treated, it can damage your cornea and lead to vision loss.

Entropion vs. ectropion: What’s the difference?

While entropion refers to an eyelid that’s turned inward, ectropion refers to an eyelid that’s turned outward, away from your eyeball.

Who does entropion affect?

Entropion is most common in people over 60 years old.

How common is entropion?

According to the American Academy of Ophthalmology, entropion affects about 2.1% of people over the age of 60.

How serious is entropion?

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

Symptoms and Causes

What are the symptoms of entropion?

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

What causes entropion?

Lower eyelid looseness (laxity) usually causes entropion. Scarring can also cause your lid to turn inward (cicatricle entropion). Entropion is common in adults over the age of 60 because their eyelid supports weaken with age, allowing their eyelid muscles to turn their eyelids in. Other causes of an in-turned eyelid include an eye injury, infection or 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 their eyelid.

Diagnosis and Tests

How is entropion diagnosed?

Your healthcare provider diagnoses entropion during an eye exam. Additional tests aren’t usually necessary.

Management and Treatment

How do you fix entropion?

Your healthcare provider may treat entropion a number of ways. Common entropion treatments include eye drops, soft contact lenses, tape or stitches, Botox® and surgical entropion repair.

Lubricating eye drops

Lubricating your eye with ointment and artificial tears is important to provide moisture and relieve discomfort. This isn’t a long-term solution, though.

Soft contact lenses

Your healthcare provider might recommend wearing soft contact lenses to protect your eyes from irritation. Contact lenses act as a bandage to help ease your symptoms. They’re available with or without a vision prescription.

Tape or stitches

Tape can be used to reposition the eyelid temporarily. Or for a longer-lasting solution, your healthcare provider can numb your eyelid with local anesthesia and stitch it into a more favorable position. The resulting scar tissue can also help keep your eyelid turned outward for a few months. But in most cases, this isn’t a permanent fix.

Botox®

A small amount of a substance called botulinum toxin (commonly known as the brand-name Botox®) can be used to weaken your eyelid muscles that are causing your lid to turn in. This may be used every three to four months if surgery isn’t an option.

Entropion surgery

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 your eyelid. Most people go home the same day as their surgery.

Surgical entropion repair methods include:

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

Is entropion surgery necessary?

While nonsurgical treatments are helpful in the short-term, entropion surgery is usually necessary to fully and permanently correct the condition.

Are there any side effects of entropion treatment?

Most people experience temporary side effects following entropion surgery, including swelling and bruising. These symptoms are a normal part of healing and can be managed with medication and cold compresses.

How long does it take to recover from entropion surgery?

In most cases, people fully recover from surgical entropion repair in about two weeks.

Prevention

Can I prevent entropion?

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

Outlook / Prognosis

What can I expect if I have entropion?

Most people who receive treatment for entropion before it causes eye damage have a good outcome. Entropion surgery usually resolves the problem, and the condition rarely returns.

Living With

When should I see my healthcare provider?

Contact your healthcare provider if your eyelid turns inward. Even if your eyelid doesn’t appear to turn inward, seek medical treatment if you feel like something is constantly in your eye.

What questions should I ask my healthcare provider?

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?

A note from Cleveland Clinic

If you feel like you always have something in your eye, or you notice your eyelashes are turning inward, it could be entropion. It’s important to correct the problem to avoid long-term issues like corneal injury and vision loss. Talk to your healthcare provider about your treatment options so you can improve your comfort, eye health and overall quality of life.

Last reviewed by a Cleveland Clinic medical professional on 05/05/2022.

References

  • American Academy of Ophthalmology. Entropion. (https://eyewiki.aao.org/Entropion) Accessed 5/5/2022.
  • American Society of Ophthalmic Plastic & Reconstructive Surgery. Turned-In Eyelid (Entropion). (https://www.asoprs.org/index.php?option=com_content&view=article&id=94:entropion&catid=20:site-content) Accessed 5/5/2022.
  • Merck Manual. Entropion and Ectropion. (https://www.merckmanuals.com/professional/eye-disorders/eyelid-and-lacrimal-disorders/entropion-and-ectropion) Turned-In Eyelid. (https://www.asoprs.org/entropion) Accessed 5/5/2022.

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