Entropion describes the turning in of the eyelid causing the skin and lashes to rub against the surface of the eye. Often this condition is misdiagnosed as being just the lashes turning in, however even if the lashes are then removed the eye discomfort does not fully resolve as the skin of the in-turned eyelid will rub and irritate the eyeball.
The most common group of people who get entropion are the elderly with loosening of the eyelid, it can also happen in patients who have nerve damage to the muscles of the eyelid. Rarely is it caused by inflammation and scarring of the inner surface (“conjunctiva”) of the eyelid pulling the lid in wards towards the eyeball.
Children and infants can also get a form of entropion called epiblepharon.
The lashes tend to rub against the eye as a result of the eyelid turning inwards. This results in a gritty feeling, irritation, scratchiness, tearing and a red eye.
It is essential that entropion is treated as soon as possible as constant irritation of the eyeball can cause loss of vision by scarring and or infection.
In addition long term malposition of the lid will lead to structural changes to the lid.
Temporary treatments are available. However the effect of these procedures do not last and so surgery is required for an adequate repair.
Surgery for entropion requires the tightening of the tendon of the eyelid and more importantly re-attaching the “retractor” muscle within the eyelid. This muscle is a very small muscle that can be difficult to find. If it is not properly re-attached the chance of recurrence of the entropion is high.
The operation is a day surgical procedure under local anaesthesia with sedation.
No bandage is required. Bruising may last 1-2weeks, but often there is little or no postoperative bruising. The lid can look a little tight and will relax to a natural curve within 2-3 months. Usually there are sutures which need removing and these are positioned under the lower eyelashes or in the corners of the eyelid.
Any surgery carries risk however the risks for this procedure are low and will be discussed fully at the time of your consultation. Overall the risk to the eye and vision if the operation is not performed outweigh any risk of the operation.
As we age, our tissues change, however as long as the retractor muscle is adequately re-inserted it is very uncommon for redo surgery to be required.
Some children will grow out of this condition, so if the entropion is mild and the patient is monitored for ongoing damage to the surface of the eye, surgery may sometimes be avoided.
In adults surgery is nearly always required irrespective of the age of the patient.
