Entropion
Entropion occurs when the eyelid turns inward, causing the lashes to rub against the eye. Learn the symptoms, causes, diagnosis and when treatment is required.
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Denise DouthwaiteWhat Is Entropion?
Entropion is a condition where the eyelid turns inward, causing the eyelashes to rub against the surface of the eye, a phenomenon known as trichiasis. This contact can lead to irritation, pain, watering, redness, and corneal damage if left untreated.
Entropion is typically age-related but may also follow scarring, inflammation, or trauma. It often fluctuates in severity, worsening with blinking, eye rubbing, or tiredness.
Early specialist assessment is essential to prevent progressive corneal damage from repeated lash abrasion. Surgical correction is highly effective and relieves symptoms in the majority of patients.
Symptoms of Entropion
Severe or untreated cases can cause corneal abrasions and ulceration, which require urgent specialist review to prevent lasting vision damage.
Causes & Risk Factors
Entropion occurs when the eyelid retractors and surrounding supporting tissues weaken or become disrupted. The underlying cause determines the most appropriate surgical approach.
Involutional (Age-Related)
The most common cause of entropion, age-related weakening of the lower eyelid retractors and horizontal lid laxity allows the lid to rotate inward. It often fluctuates, worsening with blinking, rubbing, or tiredness.
Cicatricial Entropion
Scarring of the conjunctiva or posterior eyelid lamella from chronic inflammation, chemical or thermal burns, trauma, or previous surgery contracts the inner eyelid surface, rotating the lid margin inward.
Spastic Entropion
Involuntary spasm of the orbicularis oculi muscle pulls the eyelid inward. It may be triggered by ocular irritation, inflammation, or eye patching, and can be intermittent or persistent.
Congenital Entropion
A rare developmental condition seen in newborns and infants, most commonly affecting the lower lid. It is distinct from epiblepharon, a fold of extra skin that directs lashes inward, which is more common in children of East Asian descent.
Mechanical Causes
Eyelid masses, cysts, or structural deformities can exert rotational forces on the eyelid, displacing the lid margin inward. Addressing the underlying structural abnormality is an essential part of treatment.
Diagnosis and Assessment
Assessment combines eyelid examination, functional testing, and corneal evaluation to confirm the entropion subtype and guide the choice of surgical correction.
Eyelid Laxity Testing
Snap-back and horizontal distraction tests assess the degree of lower eyelid laxity. Quantifying laxity determines whether horizontal lid tightening is required as part of the surgical correction.
Lid Retractor Evaluation
The integrity and function of the lower lid retractors are assessed, as their disinsertion or weakness is central to involutional entropion. The type of repair is determined by the specific retractor deficiency identified.
Corneal Examination
The cornea is examined carefully for abrasions, punctate epithelial erosions, and ulceration caused by repeated lash contact. Corneal involvement determines the urgency of intervention.
Structural and Lash Assessment
The eyelid is inspected for scarring, posterior lamellar shortening, and inflammation. Lash position and lid stability are documented to plan the surgical approach and confirm the entropion subtype.
When to Seek Advice
Seek review if you notice any of the following:
- Lashes visibly rubbing against the eye surface
- Redness or discomfort that persists or recurs
- Recurrent watering of the eye
- Pain or discomfort when blinking
- Blurred or fluctuating vision
- A sudden inward turning of the eyelid
“Urgent evaluation is required if pain, photophobia, or a suspected corneal ulcer develops, lash abrasion can cause rapid corneal injury that threatens vision if not treated promptly.”
Meet the Team
Where to Find Us
Three convenient locations across West Yorkshire. Visit us for consultations, diagnostics, and treatments.
Bolton
136 – 140 Newport St
Bolton, Greater Manchester
BL3 6AB
Huddersfield
Woodlands, 4 Longbow Close
Huddersfield, HD2 1GQ
Book an Entropion Assessment
If your eyelid is turning inward or your lashes are rubbing against your eye, an early specialist assessment at The Eye Doctor Clinic will confirm the diagnosis and arrange appropriate surgical treatment before corneal damage occurs.
