Entropion

Overview

Entropion is an eye condition in which the eyelid turns inward toward the eye. As a result, the eyelashes and skin of the eyelid can rub against the surface of the eye. This rubbing may irritate the cornea, which is the clear front part of the eye, and the conjunctiva, the thin tissue covering the white of the eye.

Entropion most often affects the lower eyelid, but it can involve the upper eyelid as well. It may occur in one eye or both eyes. The condition is more common in older adults because eyelid tissues can become looser with age, but it can also happen after injury, inflammation, surgery, or due to certain eye or skin conditions.

Entropion can range from mild and occasional to constant and uncomfortable. Because ongoing eyelash contact can damage the eye surface, medical assessment is important if symptoms suggest the eyelid is turning inward.

Symptoms

Symptoms of entropion are usually caused by eyelashes or eyelid skin rubbing against the eye. They may be intermittent at first and become more persistent over time.

• A feeling that something is in the eye
• Eye redness or irritation
• Watery eyes or excessive tearing
• Increased sensitivity to light or wind
• Burning, stinging, or scratchy sensation
• Mucus discharge or crusting around the eyelids
• Blurred vision, especially when the eye is watering
• Eye pain if the cornea becomes irritated or scratched
• Visible inward turning of the eyelid

Some people notice that symptoms worsen when they blink, squeeze their eyes shut, or look downward. If the cornea is affected, discomfort may increase and vision may become less clear.

Causes and Risk Factors

Entropion develops when the normal position and support of the eyelid are altered. Several factors may contribute to this change.

• Age-related tissue changes: With aging, the muscles and tendons that support the eyelid can weaken, allowing the eyelid to rotate inward.
• Scarring: Scars on the inner surface of the eyelid may pull the lid inward. Scarring can result from inflammation, trauma, burns, or previous surgery.
• Eye inflammation: Long-term irritation or infection can change eyelid structure and function.
• Muscle spasm: Irritation of the eye may trigger eyelid muscles to tighten, temporarily turning the eyelid inward.
• Congenital factors: Rarely, babies are born with an inward-turning eyelid or eyelashes that point toward the eye.
• Previous injury or surgery: Trauma or procedures involving the eyelid or surrounding tissues may affect eyelid position.

Risk factors include older age, a history of eye inflammation, eyelid scarring, previous eyelid surgery, and certain skin or autoimmune conditions that affect the eyelids or eye surface.

Diagnosis

An ophthalmologist can diagnose entropion through an eye examination. The doctor will look at the eyelid position, eyelash direction, tear film, and the surface of the eye. The examination may include asking the patient to blink, close the eyes tightly, or look in different directions to see whether the eyelid turns inward during movement.

The cornea may be checked for scratches, irritation, or other surface damage. The doctor may also examine the inside of the eyelid to look for scarring or inflammation. In many cases, diagnosis is made during a standard clinical examination and does not require complex testing.

It is important to distinguish entropion from other eyelid conditions, such as ectropion, in which the eyelid turns outward, or trichiasis, in which eyelashes grow in the wrong direction while the eyelid position is otherwise normal.

Treatment Options

Treatment depends on the cause, severity, symptoms, and the condition of the eye surface. The main goals are to protect the cornea, relieve irritation, and restore a safer eyelid position.

Temporary Measures

In some cases, temporary approaches may be used to reduce rubbing and protect the eye surface while planning further treatment. These may include protective lubrication, eyelid taping, or other supportive measures performed or recommended by an eye care professional. These options do not usually correct the underlying eyelid position permanently.

Procedural and Surgical Treatment

When entropion is persistent or causing corneal irritation, a procedure or surgery may be recommended. Surgical treatment is often aimed at tightening, repositioning, or repairing the eyelid structures so the lid rests in a more normal position. The specific technique depends on whether the cause is age-related looseness, scarring, muscle imbalance, or another factor.

If entropion is related to scarring or inflammation, additional management may be needed to address the underlying condition and reduce further damage to the eyelid and eye surface. The ophthalmologist will discuss suitable options, expected recovery, and possible risks based on the individual situation.

When to See a Doctor

A person should see an eye doctor if they notice persistent eye irritation, tearing, redness, or a sensation that eyelashes are rubbing against the eye. Medical evaluation is especially important if the eyelid appears to turn inward.

Urgent eye care is recommended if there is eye pain, worsening redness, light sensitivity, reduced or blurred vision, discharge, or suspected injury to the eye surface. These symptoms may indicate corneal irritation or damage that needs prompt attention.

Early assessment can help protect the eye surface and guide appropriate treatment. International patients who have ongoing eyelid discomfort or visible eyelid changes may benefit from evaluation by an ophthalmologist experienced in eyelid and ocular surface conditions.