Entropion

When you have entropion, your eyelid turns inward, causing your skin, eyelashes, and eye surface to rub together. It causes irritation and discomfort. Your eyelid may tilt inward with entropion either constantly or only when you blink vigorously or close your eyes tightly. Entropion often only affects the lower eyelid and is more prevalent in elderly persons.

Entropion symptoms can be reduced with the aid of artificial tears and lubricating creams. Nonetheless, surgery is frequently required to entirely treat the disease. Entropion can harm your cornea, infect your eyes, and impair your eyesight if it is not treated. It can also damage the translucent covering that covers the front of your eye.

Entropion: Causes

The following are the important causes of developing entropion −

• Muscular lassitude. The tendons and muscles behind your eyes tend to sag as you get older. Entropion is most frequently caused by this.

• Scars or signs of prior surgery. The natural curvature of the eyelid can be distorted by skin scarring caused by chemical burns, trauma, or surgery.

• Eye disease. Several poor nations in Africa, Asia, South America, the Middle East, and the Pacific Islands suffer from trachoma, an eye illness. Entropion, blindness, and scarring of the inner eyelid can result from it.

• Inflammation. You can try to rub or squeeze your eyelids shut to reduce eye irritation brought on by dryness or inflammation. This may cause the eyelid muscles to spasm and cause the lid's edge to slide inward towards the cornea (spastic entropion).

• Developmental difficulty. An additional fold of skin on the eyelid that results in turned-in eyelashes may be the source of entropion when it is congenitally present (existing from birth).

Entropion: Symptoms

The patient with entropion mainly presents with the following symptoms that include −

• The impression that there is something in your eye

• A reddened eye

• Eye sensitivity or discomfort

• Sensitivity to the wind and light

• Moist eyes (excessive tearing)

• Crusting on the eyelids and mucus discharge

When to Visit a Doctor?

If you have been told you have entropion and you suffer any of the following −

• Your eyes' redness rises quickly

• Pain

• Responsiveness to light

• Reduced vision

These are indications of corneal damage, which might impair your eyesight.

If you feel as though there is always something in your eye or if you observe that portions of your eyelashes appear to be moving inward towards your eye, schedule an appointment with your doctor. Entropion might permanently harm your eye if you don't address it promptly. Before your appointment, start moisturizing your eyes with eye ointments and artificial tears to safeguard them.

Entropion: Risk Factors

Several factors play an important role in the development of entropion which includes −

• Age. Your chances of developing the condition increase with age.

• Previous trauma or burns. The scar tissue that results from a burn or other facial injury may increase your chance of developing entropion.

• Infection with trachoma. Those who have had trachoma are more prone to develop entropion because this illness can leave scars on the inner eyelids.

Entropion: Diagnosis

The diagnosis of the entropion is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

Typically, a regular eyecheck and physical may detect entropion. During the examination, your doctor could tug on your eyelids, urge you to blink or firmly close your eyes, or both. This enables him or her to evaluate the tightness, tone, and location of your eyelid's muscles.

Your doctor will also check the surrounding tissue to see whether the entropion is brought on by scar tissue, past surgery, or some other problem.

Entropion: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

The method of treatment is determined by the cause of your entropion. There are nonsurgical options available to manage symptoms and safeguard your eye.

When you treat the inflamed or infected eye, your eyelid may return to its natural alignment when active inflammation or infection results in entropion (spastic entropion). Entropion, however, could continue even after the other problem has been addressed if tissue scarring has taken place. In most cases, surgery is necessary to treat entropion, however, temporary solutions may be helpful if you can't endure surgery or have to put it off.

Therapies

• Soft-lens disposables. Your optometrist can advise using a particular kind of soft contact lens as a form of corneal bandage to alleviate discomfort. They may be purchased with or without a prescription for refractive surgery.

• Botox. Lower eyelids can shift outward when botulinum toxin (Botox) in small doses is injected into the area. A series of injections may be given to you, with effects lasting up to six months.

• Stitching causes the eyelid to turn outward. Using a local anesthetic, this surgery can be carried out in your doctor's office. Your doctor will numb the eyelid before stitching it numerous times along the damaged eyelid.

• The eyelid is turned outward by the sutures, and the ensuing scar tissue maintains its position even after the stitches are taken out. Your eyelid could move back inward after many months. So, this method isn't a permanent fix.

• Body tape. Your eyelid can be taped with special skin-transparent tape to prevent it from turning in.

Surgical Treatment

Surgical treatment may be required in severe cases. Your surgical procedure will be determined by the state of the tissue around your eyelid and the underlying reason for your entropion.

Your surgeon will probably cut a tiny portion of your lower eyelid if the cause of your entropion is age-related. The afflicted tendons and muscles are made tighter as a result. In the outside corner of your eye or just below your lower eyelid, you'll need a few sutures.

A mucous membrane transplant utilizing tissue from the roof of your mouth or nasal passages may be performed by your surgeon if you have scar tissue on the inside of your lid, have undergone trauma, or have had prior procedures.

You might need to take rest after surgery. For a week, apply an antibiotic ointment on your eye. Periodically use cold compresses to reduce bruising and swelling

Entropion: Prevention

Entropion can seldom be stopped. The trachoma infection-related kind could be prevented. After visiting a region where trachoma infection is widespread, if your eyes start to become red and itchy, get checked out and treated very away.

Conclusion

Others may be consulted to help with management even though the ophthalmologist is virtually always engaged in the care of individuals with an eyelid deformity. This operation can also be handled by a face plastics surgeon. The nurses are an essential part of the interprofessional team since they will keep an eye on the patient's vital signs and look for any indicators of a worsening condition.