Entropion is a condition in which the eyelid folds inward, causing the skin on eyelashes to rub against the conjunctiva (the surface of the eye) and the cornea. This rubbing causes irritation, possibly even leading to corneal abrasion.
If it is left untreated, it may lead to self-inflicted trauma caused by rubbing the eyes, and to scarring of the cornea. Untreated entropion can also result in eye infections due to opportunities for bacteria created by scratches on the cornea.
Entropion can be unilateral (affecting only one eye), but can also be bilateral (affecting both eyes). The reverse condition, in which the eye turns outward, is known as ectropion.
What Are the Signs and Symptoms of Entropion?
If you are suffering from an inward-turned eyelid, you are likely to experience:
- Pain and irritation, as though a foreign object were lodged in your eye
- Redness of the affected eye
- Difficulty opening the affected eye
- Sensitivity to light (photophobia) and to wind
- Excessive tear production
- Mucus discharge
- Corneal ulcers
- Poor vision (especially if there has been damage to the cornea)
If you are experiencing these symptoms, it is important that you make an appointment to see an ophthalmologist or optometrist as soon as possible, in order to avoid serious damage to your eye.
No special tests are necessary to diagnose entropion, but damage of the cornea related to the entropion is analyzed by using a slit lamp biomicroscope and fluorescein dye.
What Causes Entropion?
Entropion can be congenital (i.e., the sufferer may be born with it) or acquired. Congenital cases often are resolve themselves as the infant grows. Acquired causes include aging in the context of lid laxity in people with small eyelids, facial nerve paralysis (FNP), trauma, neoplasms (tumor-like growths), or scarring associated with infections such as trachoma.
How Is Entropion Treated and Prevented?
Congenital cases often do not need to be treated because they are self-limiting and will eventually become normal as the orbit increases in size with normal growth.
Management of the entropion depends on whether there is corneal damage. Often, simple lubrication is sufficient to address any sensitivity caused by the entropion. In some cases, if the lashes are not causing any major damage to the cornea, it is enough for your eye care physician to monitor the entropion closely.
Surgery to Correct Entropion
Prior to undergoing surgery to correct the inward turn of your eyelid, local anesthetics will be injected into the muscles surrounding the eye (in some cases you may be given a general anesthetic, but this is not the rule).
What happens next will depend on the cause and severity of your entropion; if the problem is caused by loose skin around the eyelid, this excess skin will be removed. In some cases it may be necessary to shorten tendons or muscles.
It is also sometimes possible to correct entropion with non-incisional surgery; in such cases, the eyelid is everted (turned outward) with well-placed sutures.
Regardless of what type of entropion surgery you have, you will probably be able to go home the same day, and you should expect to find that the condition is resolved immediately.
You should not experience any further pain or irritation, and your eye should heal within a week or so as long as you are conscientious about applying the antibiotic ointment your doctor will prescribe for you in order to prevent infection.
Questions to Ask Your Doctor About Entropion
- My newborn baby rubs his or her eyes frequently; is it possible that he or she is suffering from entropion?
- The pain caused by my turned-in eyelid is very bad; how soon can I have surgery performed to correct it?
- Is it possible that I have contracted trachoma infection?
- After my entropion has been corrected, can I expect my vision to return to normal? Is there a chance that permanent damage has been done?