Understanding Entropion (Inward Turning Eyelid)

Entropion develops when the normal tension and support structures of the eyelid are disrupted, causing the lid margin to roll inward. Several factors can contribute to this condition.

• Age-Related Changes: The most common cause. As we age, the tendons and muscles that hold the eyelid in place weaken and relax, allowing the lid to turn inward. Involutional (age-related) entropion typically affects the lower eyelid.
• Scarring of the Inner Eyelid (Cicatricial Entropion): Scarring from conditions such as trachoma, chemical burns, trauma, or prolonged inflammation can cause the inner surface of the eyelid to contract and pull the lid edge inward.
• Spastic Entropion: Muscle spasms around the eye — often triggered by irritation, infection, or following eye surgery — can temporarily cause the eyelid to turn inward.
• Congenital Entropion: Rarely, entropion can be present from birth due to an abnormality in the eyelid structure or development, requiring early evaluation and treatment.

While home remedies cannot correct entropion, they can provide temporary relief from symptoms while awaiting medical treatment. These measures do not address the underlying structural problem and should not replace professional care, especially if the cornea is at risk.

• Lubricating Eye Drops and Ointments: Artificial tears or lubricating eye ointments can reduce friction and soothe irritation caused by eyelashes rubbing against the eye surface.
• Soft Tape or Eyelid Taping: Gently taping the lower eyelid downward with medical-grade skin tape can temporarily hold the lid in a normal position, offering relief between medical appointments.
• Avoiding Eye Rubbing: Rubbing the eyes can worsen the inward turning and increase the risk of corneal damage. Using cool, damp compresses instead can ease discomfort.

Treatment for entropion depends on the underlying cause and severity of the condition. The goal is to protect the cornea and restore the eyelid to its proper position.

Non-Surgical Treatment

• Botulinum Toxin (Botox) Injection: In cases of spastic entropion, a small Botox injection into the eyelid muscles can temporarily relax the spasm and restore normal lid position, providing relief for several months.
• Temporary Suture Technique: Temporary sutures placed in the eyelid can evert the lid margin, offering short-term correction while the patient is being prepared for definitive surgical repair.

Surgical Treatment

• Horizontal Eyelid Tightening (Lateral Tarsal Strip): The most common surgical approach for age-related entropion. The lower eyelid is tightened by shortening and reattaching the horizontal tendons, restoring the lid to its correct outward position.
• Everting Sutures: Permanent sutures are placed through the eyelid to rotate the lid margin outward and maintain normal alignment.
• Posterior Lamellar Repair (for Cicatricial Entropion): When scarring of the inner eyelid is responsible, the scar tissue is released and the lid is reconstructed using grafts from the mucous membrane or other tissue sources.

After treatment for entropion, the following habits can help protect eye health and prevent recurrence or complications.

• Use Prescribed Eye Drops Regularly: Keeping the eye surface lubricated helps prevent corneal damage, especially during the recovery period after surgery.
• Attend Follow-up Appointments: Regular check-ups allow your oculoplastic surgeon to monitor healing and identify any early signs of recurrence.
• Protect Eyes from Irritants: Avoid dust, wind, and smoke that can exacerbate eye irritation. Wearing protective eyewear outdoors can be helpful.
• Avoid Eye Rubbing: Rubbing can disturb healing tissues and potentially contribute to recurrence of the inward lid turning.