Entropion: Symptoms, Causes, Treatment

What are the symptoms of entropion?

Entropion is a condition in which the eyelid (usually the lower eyelid) turns inward, causing the eyelashes and skin to rub against the surface of the eye. This can lead to irritation, redness, discomfort, and other symptoms. Common symptoms of entropion include:

1. Eye irritation: The inward-turning eyelid and eyelashes can rub against the surface of the eye (cornea), causing irritation, redness, and a feeling of something in the eye (foreign body sensation).
2. Tearing: Excessive tearing (epiphora) can occur as a result of the irritation caused by the eyelashes rubbing against the eye.
3. Sensitivity to light: Increased sensitivity to light (photophobia) may occur due to the irritation of the cornea.
4. Blurred vision: The constant irritation and tearing can cause temporary blurring of vision.
5. Mucous discharge: The eye may produce a sticky or mucous-like discharge in response to the irritation.
6. Corneal abrasions or ulcers: In severe cases or if left untreated, entropion can lead to corneal abrasions (scratches on the cornea) or ulcers (open sores on the cornea), which can cause further discomfort and potential vision problems.

What are the causes of entropion?

Entropion is typically caused by age-related changes in the eyelid tissues, but it can also be due to other factors. Some common causes and risk factors for entropion include:

1. Age-related changes: As people age, the muscles and tissues that support the eyelids can weaken, leading to eyelid malposition such as entropion.
2. Eyelid scarring: Scarring of the inner surface of the eyelid, often due to injury, surgery, or chronic inflammation, can cause the eyelid to turn inward.
3. Muscle weakness: Weakness or laxity of the muscles that control eyelid movement can contribute to entropion.
4. Eyelid spasms: Conditions that cause repeated spasms or twitching of the eyelids, such as blepharospasm, can lead to entropion.
5. Congenital factors: Some people may be born with anatomical abnormalities that predispose them to developing entropion.
6. Previous eye surgery: Certain types of eye surgery, particularly surgeries that involve the eyelids or the tissues around the eyes, can increase the risk of entropion.
7. Chronic eye infections or inflammation: Conditions that cause chronic irritation or inflammation of the eyelids, such as chronic blepharitis or trachoma, can lead to entropion.
8. Facial nerve palsy: Damage to the facial nerve, which controls the muscles of the face, can lead to weakness or paralysis of the muscles that control eyelid movement, increasing the risk of entropion.
9. Sun damage: Chronic exposure to ultraviolet (UV) radiation from the sun can contribute to the aging process of the skin and tissues around the eyes, potentially leading to entropion.

It’s important to consult an eye care professional if you suspect you have entropion, as early diagnosis and treatment can help prevent complications and improve symptoms.

How is the diagnosis of entropion made?

The diagnosis of entropion is typically made based on a thorough eye examination by an eye care professional. Here’s how the diagnosis is usually made:

1. Medical history: Your doctor will ask about your symptoms, any previous eye conditions or surgeries, and any other relevant medical history.
2. Physical examination: Your doctor will examine your eyelids, eyelashes, and the surface of your eye (cornea) to assess the position of the eyelid and look for signs of irritation or damage.
3. Eyelid eversion: Your doctor may gently turn your eyelid (evert it) to examine the inner surface and check for signs of scarring, irritation, or misalignment.
4. Tear film evaluation: Your doctor may perform tests to evaluate the quality and quantity of your tears, as entropion can lead to excessive tearing (epiphora).
5. Corneal assessment: Your doctor may examine your cornea using a special dye (fluorescein) and a blue light to check for signs of corneal abrasions or ulcers caused by the inward-turning eyelid.

In some cases, additional tests such as imaging studies (e.g., ultrasound) or measurements of eyelid position and function may be performed to help confirm the diagnosis and determine the severity of the entropion.

If you are diagnosed with entropion, your doctor will discuss treatment options with you based on the underlying cause, severity of symptoms, and your overall eye health.

What is the treatment for entropion?

Entropion is a condition where the lower eyelid turns inward, causing the eyelashes to rub against the cornea, leading to irritation, redness, and potential damage to the cornea. The treatment for entropion depends on the severity and type of entropion, as well as the underlying cause. Here are some common treatments:

1. Conservative management: In mild cases of entropion, conservative management may be sufficient. This includes applying lubricating eyedrops or ointments to reduce irritation and discomfort.
2. Eyelid taping: A small piece of tape is applied to the eyelid to gently lift it outward, allowing the lashes to move away from the cornea.
3. Eye shields: An eye shield or a small plastic shield is placed over the eye to protect it from further irritation.
4. Surgical correction: In more severe cases, surgery is often necessary to correct the underlying anatomy and prevent further complications. There are several surgical procedures that can be performed, including:
   • Reattachment surgery: The eyelid is reattached to its normal position using sutures or stitches.
   • Recession surgery: A section of the eyelid is removed and reattached at a lower position to reduce its curvature.
   • Tarsal strip procedure: A small piece of cartilage and muscle is removed from the upper eyelid and reattached to the lower eyelid to help lift it outward.
   • Canthoplasty: A procedure that involves tightening the muscles around the corner of the eye (canthus) to help lift the eyelid outward.
5. Botulinum toxin injections: Botulinum toxin injections can be used to weaken the muscles around the eye, which can help relax the eyelid and reduce its curvature.
6. Prosthetic eye implant: In some cases, a prosthetic eye implant may be necessary if there is significant damage to the eye or if the entropion is caused by a congenital condition.

It’s essential to consult an ophthalmologist or an eye specialist for proper diagnosis and treatment of entropion. They will assess your condition and recommend the most appropriate course of treatment based on your individual needs.