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What is entropion, what causes it and what surgery is done?


Entropion is a rolling in of the eyelid. It can result in the eyelashes rubbing against the eyeball and can be uncomfortable. It most commonly affects the lower eyelid although it can affect the upper eyelid as well. Involutional entropion is the term given to the rolling in of the eyelid that develops with age.



What is the difference between entropion and ectropion?


Entropion is where the eyelid margin rolls inwards to wards the eye whilst ectropion is where the eyelid rolls outwards away from the eye.



What causes the eyelids to turn in?

  • Age - Most commonly the eyelids turn in with age due to increase horizontal eyelid laxity and weakening of the lower eyelid muscle known as the lower eyelid retractor.

  • Trauma - Scarring that forms on the inner surface of the eyelid from injury can lead to entropion.

  • Trachoma - This condition leads to the inner surface of the eyelid to develop scar tissue. This increase the risk of cicatricial ectropion developing.

  • Spastic entropion - this often accompanies involutional entropion where eyelid irritation or the existing eyelid laxity causes the orbicularis oculi muscle to spasm resulting in turning in of the eyelid.

  • Congenital - This is rare but is the term given when entropion is present at birth.


How is entropion treated?


If it is not severe treatment can be with eye drops or artificial tears for comfort or by placing tape on the skin to pull the lashes back out or even botulinum toxin injection which might give relief for a few months. A permanent solution is with surgical correction usually under local anaesthesia. There are different techniques for entropion repair depending on the cause. The aim is to correct the eyelid malposition and treat any horizontal laxity that may be present.



How long does entropion surgery take to heal?


The surgical procedure is usually a day case done under local anaesthetic. Sedation can be used if you are nervous. You are usually able to go home the same day. A patch is placed on the eye for a day to reduce the swelling and you can remove it yourself the next day. The vision may be blurred due to ointment being placed in the eye prevent it getting dry.


Expect there to be significant swelling and some bruising for a week or two. This will settle and you can resume your normal activities after 2 weeks.



Can entropion cause blindness?


Mild cases tend not to cause blindness. In more severe cases the eyelashes can rub against the eye and scratch the eye causing corneal abrasions. Continuous corneal abrasions can lead to scarring of the front surface of the eye and lead to chronic inflammation and permanent damage. This damage can then affect your vision. The excessive tearing from the irritation on the eye from the lashes can cause blurred vision.



How common is entropion?


Entropion is very rare in children and young adults when there is minimal laxity in the eyelids and the canthal tendon that supports the eyelid is tight. Over the age of 60 there is increased laxity and it can affect about 2% of the population.



How much does entropion surgery cost?


The cost of the surgery is in the region of 2000 pounds per eye depending on the cause and the surgical procedure required.