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A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Entropion

Last reviewed: November 14, 2010.

Entropion is 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 or 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:

Symptoms

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:

Calling your health care provider

Call for an appointment with your health care provider if:

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

  • Decreasing vision

  • Light sensitivity

  • Pain

  • Eye redness that increases rapidly

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

  1. Howard GR. Eyelid retraction. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 12.4.

Review Date: 11/14/2010.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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What works?

  • Interventions for treating an inward turning lower eyelid in the elderly Interventions for treating an inward turning lower eyelid in the elderly
    Entropion is the inward turning of the eyelid, causing rubbing of the eyelashes and eyelid skin against the surface of the eye. It is one of the commonest forms of eyelid problems in older people and it more frequently involves the lower eyelid. In the early stages not all people require treatment but eventually every movement of the eye or eyelid causes trauma to the corneal surface which may lead to infection and ulceration with visual impairment. Surgery in the form of horizontal and vertical eyelid tightening is needed when the condition is severe and causes trauma to the cornea. The review authors searched the medical literature and found a single trial that met the inclusion criteria of the review. Sixty‐three participants with lower eyelid entropion were enrolled and randomised to either everting sutures alone or everting sutures and a lateral tarsal strip. Eight participants were lost to follow‐up. The trial showed that the combination of horizontal and vertical eyelid tightening with everting sutures and lateral tarsal strip is highly efficient for entropion compared to vertical tightening with everting sutures alone. Further research is needed to provide more credible evidence for the comparison of surgical treatments to correct an inward turning eyelid.
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