Entropion
Treatment

Entropion occurs when the eyelid margin turns inward, causing the eyelashes to rub the cornea. This mechanical contact often leads to stinging, burning, pain and light sensitivity. If untreated, repeated abrasion can result in corneal scarring and, in severe cases, vision loss.

Weakness of eyelid tissues, muscle imbalance or prior surgery can cause the eyelid to rotate inward. In addition to functional problems, entropion can be cosmetically distressing; surgical correction is commonly planned carefully to restore both form and function.

As entropion progresses, patients commonly experience:

• Pain and irritation: Constant rubbing of the lashes causes stinging, burning and discomfort.
• Excess tearing and mucus: Reflex tearing often coexists with ocular irritation.
• Light sensitivity and blurred vision: Corneal surface damage can reduce visual clarity.
• Morning crusting: Inflammatory discharge may make it hard to open the eye on waking.
• Risk of corneal disease: Ongoing lash trauma increases the risk of corneal ulceration, infection and scarring.

Entropion can have several causes. The most common include:

• Involutional (age-related) entropion: Loss of eyelid tissue elasticity and weakening of supporting structures is the most frequent cause.
• Congenital entropion: Present at birth in some infants and often corrected surgically in early life.
• Scar contracture: Chemical burns, trauma or prior surgery may cause scarring that pulls the lid inward.
• Infectious causes (e.g. trachoma): Endemic infections can produce eyelid scarring and inward rotation of lashes.
• Herpes zoster ophthalmicus: Severe ocular herpes can damage eyelid tissues and lead to chronic entropion.

Entropion is not only a medical issue but can also be cosmetically distressing. For more about eyelid appearance and aesthetic options, see our Eye Diseases & Eyelid Aesthetics section.

In mild cases, temporary measures can protect the cornea and relieve symptoms while definitive treatment is planned.

• Lubricating drops and ointments: Reduce friction and protect the ocular surface.
• Bandage contact lenses: Provide temporary relief by separating lashes from the cornea.
• Botulinum toxin injections: May temporarily evert the lid margin by reducing muscle spasm.
• Skin taping techniques: External support to pull the lid outward, especially during sleep.

Definitive treatment is surgical and tailored to each patient. Most procedures are performed under local anaesthesia in a clinic and take about 30–60 minutes.

1. Assessment and marking: The surgeon evaluates lid laxity, lash direction and any corneal damage, and plans the incision and technique.
2. Local anaesthesia: The eyelid area is numbed; sedation may be used when appropriate.
3. Tissue tightening / lateral tarsal strip: Shorten or tighten the lateral canthal tendon to re‑appose the lid to the globe.
4. Retractor repair or reinforcement: Reposition and strengthen retractor muscles to correct inward rotation; grafts may be used if required.
5. Dressing and follow‑up: Apply antibiotic ointment and protective dressing; most patients are discharged the same day and return for suture removal at 7–10 days.

After surgery, your doctor may recommend eye drops and a protective night patch; noticeable relief is usually felt within a few days. Since eyelid tissues may loosen again over the years, patients are also informed that an additional correction may be required in about 15% of cases.