About Entropion
Entropion is a functional eyelid disorder in which the margin of the lower or upper eyelid turns inward so the lashes rub against the cornea and conjunctiva. The constant friction increases the risk of redness, irritation and infection and can threaten vision.
Age-related tissue laxity is the most common cause, but it can also follow trauma or previous surgery. When caught early, entropion can be treated before permanent corneal damage occurs.
What Is Entropion?
Entropion is the inward rotation of the eyelid margin, causing the lashes to brush the transparent corneal surface. This mechanical contact leads to stinging, burning, pain and light sensitivity, and untreated it can cause corneal scarring and even vision loss.
Laxity of the eyelid tissues, muscle weakness or surgical scarring can rotate the lid inward. Because it is both functional and cosmetically distressing, correction is planned with great precision; aesthetic lid options are covered under eyelid surgery.
Symptoms
As entropion progresses the following become more frequent:
- Stinging, burning and pain: Constant discomfort as the lashes rub the cornea.
- Persistent watering and mucus: Reflex tearing that does not relieve the irritation.
- Light sensitivity and blurring: Corneal abrasions reduce visual quality.
- Morning crusting: Inflammatory discharge that makes the eye hard to open.
- Lashes touching the cornea: The key sign that raises the risk of ulcer and scarring.
Causes & Risk Factors
Entropion can have several causes; the most common are:
- Involutional (age-related) entropion: Collagen loss and muscle laxity — the most common cause.
- Congenital entropion: Present at birth in some infants; corrected early.
- Scarring (burns, surgery): Scar contracture pulls the lid margin inward.
- Trachoma and infections: Conjunctival scarring redirects the lashes.
- Herpes zoster ophthalmicus: Can damage lid tissue and trigger chronic entropion.
Non-surgical Approaches
In mild cases, temporary measures protect the corneal surface while definitive treatment is planned:
- Lubricating drops and ointments: Reduce friction and protect the surface.
- Bandage contact lenses: Separate the lashes from the cornea for temporary relief.
- Botulinum toxin injections: Relax spastic muscle and evert the lid margin.
- Skin taping: Pull the lid outward, especially overnight.
Surgical Treatment
Lower-Lid Tightening
The most common protocol: correct lower-lid laxity so the lashes turn outward again.
Tissue Planning
The lid margin is measured and excess skin/muscle marked.
Tendon Shortening
A small lateral-canthus incision reshapes the lax tendon.
Fixation
The lid margin is fixed to the periosteum and the lash line realigned.
A Stable, Balanced Lid Margin
Muscle Repositioning
Strengthening the retractor muscles corrects inward rotation of the upper or lower lid.
Preparation
The inner lid is sterilized and the muscle layer exposed.
Retractor Release
The weakened muscle is released and repositioned outward.
Continuous Suture
Fine sutures evert the lid margin and support the natural curve.
Fast Recovery & Symmetric Look
Which technique suits you?
The plan is chosen after assessing lid laxity, muscle strength and aesthetic goals.