Entropion Health Article

Definition

Entropion involves the turning in of the edges of the eyelid (usually the lower eyelid) so that the lashes rub against the eye surface.

Causes, incidence, and risk factors

Entropion can be present at birth (congenital).

In babies, it rarely causes problems because the lashes are very soft and do not easily damage the cornea. In older people, the condition is usually caused by a spasm and weakening of the muscles surrounding the lower part of the eye. This causes the lid to turn inward.

Although rare in North America and Europe, trachoma infection can cause scarring of the inner side of the lid, which may cause entropion. Trachoma scarring is one of the three leading causes of blindness in the world.

Risk factors for entropion are:

• Aging
• Chemical burn
• Infection with trachoma

Symptoms

• Decreased vision if the cornea is damaged
• Excessive tearing
• Eye discomfort or pain
• Eye irritation
• Redness

Signs and tests

A physical examination of the eyes and eyelids confirms the diagnosis. Special tests are usually not necessary.

Treatment

Artificial tears (a lubricant) may provide relief from dryness and keep the cornea lubricated. Surgery to correct the position of the eyelids is usually effective.

Severe cases may need surgery to protect the eye.

Expectations (prognosis)

The outlook is usually good if the condition is treated before cornea damage occurs.

Complications

Corneal dryness and irritation may increase the risk of:

• Corneal abrasions
• Corneal ulcers
• Eye infections

Calling your health care provider

Call for an appointment with your health care provider if:

• Your eyelids turn inward
• You constantly feel as though there is a foreign body in the eye

If you have entropion, the following should be considered an emergency:

• Decreasing vision
• Light sensitivity
• Pain
• Rapidly increasing redness

Prevention

Most cases are not preventable. Treatment reduces the risk of complications.

People who have recently traveled to an area where there is trachoma (North Africa, South Asia) should seek treatment if they have red eyes.

References

Howard GR. Eyelid retraction. In: Yanoff M, Duker JS, Augsburger JJ, et al, eds. Ophthalmology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 85.