Entropion

Diagnosis

Entropion is typically diagnosed during a routine eye examination and physical evaluation. During the exam, a healthcare provider may gently pull on the eyelids or ask you to blink or close your eyes tightly. This helps assess the eyelid’s position, muscle tone, and tightness.

If entropion is linked to scar tissue, a past surgery, or another condition, the doctor will also examine the surrounding tissues to determine the cause and extent of the problem.

Treatment

The treatment plan for entropion depends on its underlying cause. While surgery is often required for long-term correction, several nonsurgical methods can provide temporary relief and protect the eye from irritation or further damage.

When entropion results from inflammation or infection, known as spastic entropion, the eyelid may return to its normal position once the underlying condition is treated. However, if scarring has developed, the inward turning may persist and require additional care.

Therapies

• Soft contact lenses – Special soft contact lenses can act as corneal bandages, providing comfort and preventing the eyelashes from rubbing against the eye. These lenses are available with or without vision correction.

• Botox injections – Small doses of onabotulinumtoxinA (Botox) can be injected into the lower eyelid to help it turn outward. The effects last for about six months, and repeat treatments may be needed.

• Stitches that turn the eyelid outward – A minor procedure performed under local anesthesia, where stitches are placed in the lower eyelid to turn it outward. The scar tissue formed helps maintain the new position, although the eyelid may eventually turn inward again.

• Skin tape – Transparent medical tape can be applied to the lower eyelid to hold it in place temporarily and prevent inward turning.

Surgery

Surgery offers a permanent solution for entropion and is tailored to the cause and severity of the condition.

• Age-related entropion – A small section of the lower eyelid is removed to tighten the muscles and tendons. Stitches are usually placed at the outer corner or just below the lower eyelid.

• Entropion caused by scarring or trauma – A mucous membrane graft may be performed using tissue from the mouth or nasal passages to rebuild the eyelid’s inner lining.

Before surgery, a local anesthetic is applied to numb the eyelid area. Sedation may also be given for comfort, depending on the setting and procedure.

After surgery care

Following surgery, patients are usually advised to:

• Apply antibiotic ointment for about a week

• Use cold compresses to reduce swelling and bruising

Recovery

After surgery, mild swelling, bruising, and tightness around the eyelid are common. These symptoms generally improve within two weeks as healing progresses. Stitches are typically removed about a week after the operation, and most people experience long-lasting improvement in eyelid position and comfort.