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​What is Entropion?

An in-turning of the eyelid margin, usually of the lower eyelid. When the eyelashes rub against the front of the eye, it causes discomfort.

What are the Causes?

Entropion 1.png
Anatomy of lower eyelid (cross-section of side view)

  • Involutional (age-related) – the lower eyelid retractor muscle is dehisced and weakened from its original point of attachment. The lower eyelid supporting structures also become lax due to degeneration with increasing age.
  • Cicatricial (blepharitis, chemical injury, Steven-Johnson syndrome, ocular pemphigoid) – scarring occurs on the inner surface of the eyelid and results in in-turning of the eyelid.
  • Congenital – in-born structural abnormality of the lower eyelid retractor or the eyelid supporting structures.

The most common form of entropion is involutional entropion of the lower eyelid.

Entropion 2.png
Image showing right lower eyelid entropion.

What Symptoms does Entropion Cause?

  • Eye irritation (poking sensation)
  • Tearing/ watering of the eye
  • Red eye
  • Pain – this can sometimes result from an eye infection

What are the Treatment Options?

  • Lubricant eye ointment/gel
  • Taping of the eyelid to the cheek
  • Botox (Botulinum toxin) injection to the lower eyelid
  • Surgery

What Types of Surgery are done for the Lower Eyelid Involutional Entropion?

  • Surgery is aimed at the proper eversion of the lower eyelid to a good position. A lower eyelid tightening procedure may also be necessary.
  • A skin incision is usually made on the lower eyelid skin.
  • Surgery for entropion due to the other causes is usually more complicated, and may involve multiple surgeries.

Entropion 3.png
Image of the same patient after lower eyelid entropion corrective surgery.

Aspirin and Anticoagulants

  • These medications can cause significantly more bleeding during and after the surgery.
  • If you take aspirin, or blood-thinning agents such as warfarin, you will need to check with your physician if you could safely stop these drugs.
  • Some herbs or health supplements may also thin your blood to make surgery unsafe, please get advice from your doctor if you need to stop them before surgery.

What to Expect on the day of the Surgery?

  • Day surgery procedure.
  • A local anaesthetic injection is given to the eyelid area where surgery will be performed.
  • You will be moderately sedated but still able to respond and hear instructions given by the surgeon.
  • Midway through the surgery, your surgeon will ask you to open your eyes to assess the position of the eyelid.

What to Expect Post-Surgery?

  • Usually only mild discomfort after surgery.
  • Expect some swelling, bruising and tightness of the eyelids − these will resolve once the wounds heal.
  • Infrequently, slight over- or under-correction of the eyelid position might occur and may require additional corrective surgery.
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