Entropion

What is Entropion?

Entropion is an inturning of the eyelid margin. When the eyelid turns inward, the eyelashes and skin rub against the eye creating a red, irritated eye sensitive to light and wind. If untreated, corneal infection and scarring may result. It may be unilateral or bilateral. Acquired entropion is classified as spastic (due to eye irritation), involutional (due to aging changes), or cicatricial (due to scarring). Lower eyelid entropion (usually involutional) is much more common than upper eyelid entropion (usually cicatricial).

Acquired Entropion

Involutional entropion is the commonest form of entropion and is generally seen in patients after the 5th decade of life. It is caused by progressive weakness of the supportive structures in the lower eyelid. The tarsal plate (tarsus)is the firm part of the eyelid that gives the eyelid its normal shape. The tarsus is supported by tendons medially and laterally and by a specialized structure (the lower eyelid retractors) from below. With age, these structures develop laxity and stretch resulting in an unstable tarsal plate. As the orbicularis muscle covering the eyelid contracts during eyelid closure, the eyelid margin is rolled in toward the eye resulting in entropion.

Acute Spastic Entropion

Acute spastic entropion is an inturning of the eyelid following irritation of the eye or inflammation. It is most frequently seen following intraocular (cataract and glaucoma) surgery in a patient who has unrecognized or mild involutional (aging) eyelid changes before surgery. The eye inflammation causes sustained squeezing or squinting of the eyelids which causes the eyelid margin to roll inward.  Corneal irritation from the eyelashes rubbing against the eye may cause further irritation and inflammation worsening the problem.

Cicatricial Entropion

Cicatricial entropion results from scarring on the conjunctival side (inside) of the lower or upper eyelid. A variety of medical conditions may lead to this form of entropion. Trauma (thermal or chemical), infection, trachoma (Chlamydia), herpes, and ocular cicatricial pemphigoid (OCP) are potential causes of cicatricial entropion.

The Treatment of Entropion

Entropion Ectropion Surgery video Watch to learn more about Entropion Surgery

Surgery is usually necessary to treat entropion. A temporizing measure that may correct the eyelid malposition is taping the eyelid to evert the lid margin. Surgical tape or the sticky part of a Band-Aid, placed from the lower eyelid to the cheek area, will evert the lid and relieve corneal irritation from the eyelashes. In spastic entropion, taping the eyelid may be all that is needed. Once the inflammatory cause of the entropion is relieved, the eyelid position may be normal. A variety of surgical techniques are utilized to treat entropion. In adults, these surgeries are done under local anesthesia as an outpatient. Dissolvable sutures are preferred and the eyelid typically heals over several weeks to months.

Female, 74 years old

Entropion, right lower eyelid

Before
After
» More information on Entropion
"I could tell you 'Thank you' a million times and it still would not be enough to repay you for what you did for us! We very much appreciate you for taking great care of our son."
— Beth —
"A quick note of thanks for all of your efforts on my behalf in regard to my eyebrow work. Your entire organization deserves an A+ from my experience."
— Walter —
"In a time of fear, chaos, and pain you have provided us with some much needed comfort and reassurance. We appreciate the opportunity to have become your patient."
— Kelly —
"I love the way I look after only 3 months and I have had amazed looks and interesting and positive comments from friends and family. Thank you so much for your wonderful care."
— Judy —
"Just wanted to let you know how much we appreciate all you've done for our family, especially our son. You are according to him, AWESOME!"
— Max's family —
"I've never had such a good time in surgery. I want to thank everyone who cared for me, but a very special thanks to Dr. Klapper."
— Linda —
"I just wanted to say thank you for my new eyes. I can't believe the difference that it has made. You were all so kind and I appreciate your patience. You are the best!"
— Vicki —
"You are so patient with all my many questions, and you deserve many plaudits for your warm and friendly 'bedside manner' and your ability to explain so well."
— Faye —

Dr. Klapper treats disorders, injuries, and other abnormalities of the eyelids, eyebrow, tear duct system, eye socket, and adjacent areas of the mid and upper face.

Schedule a Consultation