Entropion: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Vompolu Kamakshi Bhaskar , Ophthalmologists

Entropion is an eye condition in which the eyelid, usually the lower eyelid, turns inward, causing the eyelashes and skin to rub against the surface of the eye. It most commonly occurs due to aging but may also result from scarring, injury, inflammation, muscle spasms, or congenital abnormalities. Symptoms include eye irritation, redness, excessive tearing, sensitivity to light, blurred vision, and a sensation of having something in the eye. Early diagnosis and appropriate treatment are essential to protect the cornea, relieve symptoms, prevent vision-threatening complications, and preserve eye health.

What are the Symptoms of Entropion?

Entropion causes symptoms such as eye irritation, redness, excessive tearing, sensitivity to light, and a feeling of something in the eye due to inward-turning eyelashes rubbing against the cornea.

Irritation and Redness

One of the most common symptoms of entropion is irritation and redness of the eye. The inward-turning eyelid causes the eyelashes to rub against the cornea, leading to discomfort and redness.

Tearing and Discharge

Excessive tearing, also known as epiphora, is another symptom. The constant irritation caused by the inward-turning eyelid can stimulate tear production. Additionally, discharge from the eye may be observed due to the irritation.

Sensitivity to Light and Wind

Individuals with entropion often experience increased sensitivity to light and wind. This sensitivity can exacerbate the discomfort and irritation caused by the condition.

Blurred Vision

In severe cases, entropion can lead to blurred vision. Continuous rubbing of the eyelashes against the cornea can cause corneal abrasions or ulcers, which can impair vision if not treated promptly.

What are the Causes of Entropion?

Entropion is usually caused by age-related weakening of eyelid muscles, but it can also result from scarring, eye infections, inflammation, or congenital factors that cause the eyelid to turn inward.

Age-Related Factors

One of the primary causes of entropion is the weakening of the muscles and tissues around the eyelid, which typically occurs with ageing. As we age, the muscles supporting the eyelids can weaken, and the tendons can stretch, leading to an inward turning of the eyelid.

Congenital Factors

Entropion can be present at birth in some cases. Congenital entropion is often due to an abnormal development of the eyelid muscles and can affect both the upper and lower eyelids. This form of entropion is relatively rare but should be addressed promptly to prevent complications.

Scarring and Trauma

Scarring from trauma, surgery, or certain inflammatory conditions can also cause entropion. When scar tissue forms on the inside of the eyelid, it can pull the eyelid inward. This is known as cicatricial entropion and can result from conditions such as trachoma, a bacterial infection that affects the eyelids.

Muscle Weakness

Certain neuromuscular conditions can lead to muscle weakness around the eyelids, contributing to the development of entropion. Conditions such as Bell palsy, which affects facial muscles, can result in an imbalance that causes the eyelid to turn inward.

Chronic Inflammation

Chronic inflammation of the eyelids, known as blepharitis, can also be a contributing factor. Inflammation can cause changes in the eyelid tissues, leading to entropion over time.

When to See a Doctor for Entropion?

Anyone with persistent eye irritation, redness, excessive tearing, sensitivity to light, or blurred vision should consult an Ophthalmologist for evaluation and treatment.

You should see a doctor if you experience:

Seek emergency medical attention immediately if you:

These symptoms may indicate serious corneal damage requiring urgent ophthalmic treatment.

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How Is Entropion Diagnosed?

The diagnosis of entropion is usually made through a physical eye examination, where a doctor observes the inward turning of the eyelid and evaluates associated irritation or damage to the eye surface.

Clinical Examination

A thorough clinical examination by an ophthalmologist is essential for diagnosing entropion. During the examination, the doctor will assess the eyelid's position, muscle tone, and overall eye health. They may also evaluate the underlying causes of the condition, such as scarring or inflammation.

Slit-Lamp Examination

A slit-lamp examination allows the ophthalmologist to examine the eye in detail. This examination can help identify any corneal abrasions, ulcers, or other complications resulting from the inward-turning eyelid.

Imaging Studies

In some cases, imaging studies such as ultrasound or CT scans may be necessary to assess the extent of underlying structural abnormalities or scarring. These imaging studies can provide valuable information for planning treatment.

What are the Treatment Options for Entropion?

Treatment options for entropion focus on relieving symptoms and correcting the inward turning of the eyelid, often starting with lubricating eye drops, ointments, or eyelid taping for temporary relief, while definitive treatment typically involves a minor surgical procedure to reposition the eyelid.

Non-Surgical Treatments

For mild cases of entropion, non-surgical treatments may be effective in providing relief and preventing complications.

Lubricating Eye Drops and Ointments

Lubricating eye drops and ointments can help reduce irritation and protect the cornea from damage. These products provide a barrier between the eyelashes and the eye's surface, reducing friction and discomfort.

Taping the Eyelid

In some cases, taping the eyelid can help reposition it temporarily. This method can be used as a short-term solution to prevent further irritation until more definitive treatment can be provided.

Botulinum Toxin Injections

Botulinum toxin injections can be used to temporarily paralyze the muscles responsible for the inward turning of the eyelid. This treatment can provide relief for several months but is not a permanent solution.

Surgical Treatments

For more severe cases of entropion, surgical intervention is often necessary to correct the eyelid's position and prevent complications.

Eyelid Tightening Procedures

Eyelid tightening procedures involve removing a small section of the eyelid to tighten the muscles and tissues, correcting the inward turning. This procedure is often performed under local anesthesia and has a high success rate.

Retractor Reinsertion

In cases where entropion is caused by muscle weakness or dislocation, retractor reinsertion may be necessary. This procedure involves repositioning and reattaching the muscles responsible for eyelid movement.

Skin Grafting

Skin grafting may be required for cicatricial entropion caused by scarring. This procedure involves removing the scar tissue and replacing it with healthy skin to restore the eyelid's normal position.

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What are the Complications of Untreated Entropion?

Untreated entropion can lead to several complications, some of which can be severe and potentially vision-threatening.

Corneal Damage

The continuous rubbing of the eyelashes against the cornea can cause corneal abrasions, ulcers, and infections. If not addressed promptly, these complications can result in permanent vision loss.

Chronic Eye Infections

The irritation and tearing associated with entropion can increase the risk of chronic eye infections, which can further damage the cornea and other eye structures.

Vision Loss

In severe cases, untreated entropion can lead to significant vision loss due to corneal damage and infections. Prompt diagnosis and treatment are essential to prevent these complications.

What is the Recovery Process for Entropion?

Recovery depends on the underlying cause and the type of treatment. Most individuals recover well after corrective surgery, with significant improvement in comfort and protection of vision. Regular follow-up ensures proper healing and early detection of recurrence.

Using prescribed eye medications, keeping the eye clean, avoiding rubbing the eye, attending follow-up appointments, protecting the eye from injury, and following postoperative instructions carefully help promote healing and preserve vision.

Recovery Includes