Entropion, (Inverted Eyelid) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Entropion (Inverted Eyelid), Diagnosis and Treatment and Related Diseases

Recently I have a 20 year old patient who has bilateral entropion which causes her lower eyelashes to turn inwards and irritate her conjunctiva and also blur her vision.

She had laser abrasion of her lower eyelashes done by an eye surgeon which gave her some relief for a few months but unfortunately the eyelashes grew back and irritated her eyes again.

She was then referred to an eye surgeon for surgical treatment of her entropion.

At the moment she is still recovering from her operation.

In fact my own mother had this same problem in her seventies due to aging and the drooping of lax eyelid muscles.

She went to an eye surgeon who did a laser removal of her lower eyelashes and tightening of the lower eyelid muscles which gave her temporary relief for a few months before it recurs again.

She went for six surgeries but the entropion recurred each time due to her aged lax eyelid muscles.

In the end she decided not to go for any more operations because she did not improve.

Entropion is depicted as an inversion (rolling inwards) of the eyelid.
Entropion is a medical disorder in which the eyelid is turned inward so that the eyelashes and skin wipe against the eye surface.

This produces irritation and discomfort.

When the patient has entropion, the eyelid may be turned in all the time or only when the patient blinks hard or squeezes the eyelids shut.

Entropion is more frequent in older adults, and it generally involves only the lower eyelid.

Artificial tears and lubricating ointments can help alleviate symptoms of entropion.

But normally surgery is required to fully correct the disorder.

Left untreated, the entropion can produce damage to the transparent covering in the front part of the eye (cornea), eye infections and vision loss.

It normally involves the lower eyelid and can induce the eyelashes to be up against the eye, which can induce irritation to the eye and even possibly damage the cornea.

Entropion is more frequent in women than in men.

Entropion is a disorder frequent in older adults that produces the eyelid to turn inward.

In mild forms the disorder can be managed with non-surgical methods, such as Botox injections, transparent tape and eye drops, but the only way to totally reverse entropion is through surgery.

1. Cicatricial entropion is produced by scarring of the conjunctiva and relative shortening of the posterior lamella due to chronic autoimmune, infectious, inflammatory, thermal, or traumatic insult.

2. Congenital entropion is a rare disorder featured by shortened posterior lamella, capsulopalpebral fascia dysgenesis, and structural weakness of the tarsal fascia.

An abnormal type of congenital entropion involves a tarsal bend, in which the upper tarsus is bent, inducing the cilia and the eyelid margin to come in direct contact with the eye globe.

3. Spastic entropion forms in reaction to acute ocular irritation or inflammation.

It often happens in patients with underlying introverted eyelid changes and is further aggravated by the corneal irritation produced by the entropion.

4. Involutional entropion is produced by horizontal laxity of the eyelid, attenuation or poor insertion of eyelid retractors, and overriding by the pre-septal orbicularis oculi muscle.

There is:
a. Overriding orbicularis oculi muscle,
b. Eyelid margin entropion, and
c. Relative enophthalmos with deep superior sulcus.

Entropion can be caused by:

1. Muscle weakness
2. Scars or previous surgeries
3. Eye infection
4. Inflammation
5. Developmental complication

The best treatment is surgery to evert the entropion.
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