Entropion: symptoms and treatment

Entropion: symptoms and treatment

Publication date: 12-04-2023

Updated on: 14-04-2023

Topic: Ophthalmology

Estimated reading time: 1 min

Entropion is a condition related to an altered position of the eyelid whereby the eyelid rim, where the eyelashes reside, is introflected (turns inward) and the eyelashes go scratchy on the cornea. 

We delve into this topic with Dr. Renato Valeri, Head of the Ophthalmology Unit at Istituto Clinico San Rocco.

Symptoms attributable to entropion

"To the naked eye the eyelid appears shorter and chubbier than usual and the eye very reddened, in addition to a very noticeable subjective sensation of discomfort complained of by sufferers. 

At first there is a sense of: 

  • annoyance,
  • discomfort,
  • redness of the eye. 

Later, this disorder can result in corneal lesions, actual ulcers that, in addition to being very painful, can lead to infection from which corneal transparency or a corneal abscess can result," as Dr. Valeri explains.

Types of entropion

Entropion may be congenital in a small percentage of cases because, normally, it is senile in nature, that is, due to a laxity of the orbicularis muscle, which no longer keeps the eyelid in contact with the eye and thus the eyelashes introflect. 

There is also, albeit less frequently, senile spasm entropion caused by overactivity of the orbicularis muscle, which causes the eyelid to contract and bring it inward. 

How to treat entropion?

For senile entropion, treatment is always surgical. Through the surgery, the eyelid is cut and shortened, and the eyelid rim is everted with resorbable stitches that reposition it to its original location.

In some cases of entropion for spastic forms, botulinum toxin injections can be performed, but these have limited efficacy over time. In fact, once the toxin is degraded by our body, usually within 2 to 3 months, the paralyzing effect of the over-contracting muscle is lost and we return to the original situation. 

Surgical intervention

This is an outpatient 20-minute procedure with infiltrative local anesthesia that requires withdrawal of antiplatelet and anticoagulant medication. 

The effectiveness of the intervention in some cases is not definitive: sometimes the laxity is such that the problem may recur over time. In fact, the eye cavity regresses as age progresses, and the periorbital fat is worn away leading to an unavoidable clinical condition known as enophthalmos, or dimpling of the eye game. No longer having the push of the eye, therefore, the eyelid turns inward. 

It is important, however, at the initial stage of surgery, not to overdo the thinning of the orbicularis muscle and skin, but to act with extreme balance: if you shorten the eyelid too much, in fact, you run the risk that the eye will not close later.

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