Entropion

Definition
Entropion involves 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 a congenital condition. 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 and weakening of the muscles surrounding the lower part of the eye, causing the lid to turn inward.

Although rare in North America and Europe, trachoma infection can cause scarring of the inner side of the lid and can cause entropion. Trachoma scarring is one of the three leading causes of blindness in the world. Risk factors for entropion are aging, chemical burn, or prior infection with trachoma.

Symptoms

     
  • Excessive tearing  
  • Eye irritation  
  • Redness  
  • Eye discomfort or pain  
  • Decreased vision if the cornea is damaged

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 with corneal ulcer may require surgery to move conjunctiva over the cornea to protect the eye from perforation.

Expectations (prognosis)

The probable outcome is good if treated before cornea damage occurs.

Complications
Corneal dryness and irritation may predispose the eye to infections or corneal abrasions and/or corneal ulcers

Calling your health care provider

Call for an appointment with your health care provider if eyelids turn inward, or if there is a persistent sensation of a foreign body in the eye. Rapidly increasing redness, pain, light sensitivity, or decreasing vision should be considered an emergency in a person with entropion.

Prevention

Most cases are not preventable. Treatment reduces the risk of complications.

Persons who have recently traveled to an area with trachoma present (North Africa, South Asia) should seek treatment if they have red eyes.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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