Entropion

1 What is Entropion?

Entropion is the inward folding of an eyelid, usually the lower eyelid, causing the eyelashes to rub against the eyeball. Entropion causes almost-constant irritation of the eyes and intense discomfort on the part of the patient, and can lead to reduced vision if left untreated.

Some patients have Entropion all the time while some only have it when blinking or squeezing the eyelids shut.

Entropion is often seen in older adults, though it can affect anyone at all ages.

Entropion cause damage to the eye, which can result in eye infections and vision loss if not treated early.

Treatment involves relieving discomfort by using artificial tears and eye ointments. Surgery is the only way to correct entropion.

2 Symptoms

Entropion may cause the following symptoms:

  • Sensation of something inside the eyes
  • Having eyelashes that are inward and rubbing against the eyeball
  • Eye irritation and pain
  • Eyes become sensitive to wind and light
  • Excessive tears in the eyes
  • Presence of mucous discharge and crusting in the eyelid
  • Reduced vision

You need to see a doctor if you experience increasingly rapid redness of the eyes, eye pain and sensitivity to light. Having reduced vision is a sign of injury to the cornea, which can lead to permanent vision loss.

As you wait for medical care, start using artificial tears and eye ointments to lubricate and protect the eyes.

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3 Causes

Entropion is caused by medical conditions or congenital defects that cause the eyelids to fold in a wrong position:

  • Having an extra fold of skin in the eyelid, causing the eyelashes to turn in
  • Having eye infection diseases like trachoma, which can scar the inner eyelid and make the eyelashes turn inward. Trachoma is more common in developing regions
  • Muscle weakness of the muscles of the eye that may be caused by aging. This is a common reason of entropion in elderly
  • Scars in the eye, eye injuries and eye surgery that distorts the eyelid

If left untreated, entropion can result in a permanent reduction in vision.

4 Making a Diagnosis

The doctor can easily diagnose entropion by closely examining your eyes and checking your symptoms. Eye conditions like entropion are usually treated by specialist doctors called ophthalmologist.

Your medical history will be assessed for previous eye injuries or surgeries. During the exam, the doctor may pull on your eyelids to check for the tone of muscles controlling the eyelid.

Before the appointment, here are things you can do in advance:

  • Make a list of things like medications and supplements
  • Prepare another list for felt symptoms and previous eye injuries and procedures.
  • You can ask questions to your doctor about your condition.

Here are some good questions to ask:

  • What are the causes of my condition?
  • Is there a need for me to have tests to check my vision?
  • Is this condition temporary or long-term?
  • Do I have other problems in the eyes?
  • What are my treatment options for entropion? What are the side effects and risks of surgery?
  • What should be the treatment option if I have other health problems?
  • Can you share me printed or online materials to help me understand my condition better?

The doctor may ask you questions about the following topics:

  • Description of your symptoms
  • History of having eye surgeries, injuries, scars and infection in the eyes
  • Use of eyedrops and medications like aspirin and other blood thinners

5 Treatment

Entropion treatment starts by protecting the eyes from further damage by applying artificial tears and eye ointments to add lubrication and reduce inflammation.

If there is active inflammation, the doctor may prescribe anti-inflammatory eye drops. Entropion caused by inflammation may disappear when the inflammation subside.

Here are other temporary treatments for entropion:

  • Using a skin tape to the eyelid to prevent it from turning inwards.
  • Using soft contact lenses that act as a bandage to the cornea to ease symptoms of entropion.
  • Applying stitches to turn the eye outward and resolve entropion. Using local anesthesia, the doctor places stitches in several locations around the eyelid. The resulting scar tissue keeps the eyelid outward after the stitches are removed. However, entropion is likely to come back after several months.
  • Injection of Botox to tighten eye muscles controlling the eyelid to make it turn outward. The effects of Botox can last up to six months

Surgery is the only way to correct entropion. If entropion is caused by aging skin and loose muscle, the surgeon removes a portion of the lower eyelid and stitch remaining edges together to tighten the skin and the muscles. You may have few stitches outside the eye and below the eyelid. If the cause is a scar tissue, it is removed, and graft (obtained from the roof of the mouth or nose) is stitched into place.

Before surgery, the doctor may numb the area around the eyelid and give you a light sedative to make you comfortable throughout the procedure. Surgery for entropion is quite short and can be done in an outpatient clinic. After the surgery, you are likely to have swelling and bruising on or around the eye that resolves in few days.

Here are some important things to do after surgery:

  • Use the prescribed antibiotic ointment according to doctor’s instructions. The antibiotic helps reduce the risk of infection. You have to use it for one week.
  • Use cold compresses to address swelling and bruising.

6 Prevention

Entropion is not entirely preventable as it may happen during aging and as a consequence of eye surgeries or injuries.

Trachoma is a significant cause of entropion in regions where it is endemic.

Trachoma is an infectious and highly communicable disease.

Avoid travelling in areas where trachoma is endemic.

7 Lifestyle and Coping

Lifestyle modifications are necessary in order to manage the symptoms of entropion.

You can relieve symptoms of entropion by frequent application of eye ointments or artificial tears to keep your cornea well lubricated.

You can also ask your doctor for instructions on using skin tape so it will gently pull the eyelid and keep it from turning in.

8 Risks and Complications

Here are the risk factors for entropion:

  • Old age
  • The previous history of eye injuries or surgeries
  • Having trachoma
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