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Entropion
Entropion is an inward turning of the lower lid margin against
the eyeball. Patients complain of the lashes rubbing against
the eye, which can cause damage to the cornea by ulceration
and infection.
 The
basic causes are:
AGE: The eyelid is held in goad position by two sets
of muscles. One pulls the eyelid away from the eyeball, while
the other turns the lid toward the eyeball. When an imbalance
in this system favors the set pulling toward the eye, an entropion
results. This imbalance is a natural consequence of the aging
process.
SCARRING: This may result from many different diseases
or injuries again causing the characteristic imbalance in
the muscles controlling the lower lid.
CONGENITAL: An entropion from birth
is very rare.
SPASTICITY: Here the eyes are vigorously
closed because of inflammation, eye surgery or injury. The
lower lid may turn on itself due to this strenuous attempt
at closure.
Treatment is surgical in most cases — except for the
temporary spastic entropion, which will clear up when the
Inciting agent is removed.
The purpose of surgery is to strengthen the muscles that draw
the lid away from the eye. Sometimes a better approach is
to tighten up the whole lid to put it in better position.
Each patient is different, and many factors are taken into
consideration in planning the correct surgical procedure.
Entropion repair is done with a local anesthetic as an outpatient,
no hospitalization and is well tolerated.
Potential problems with this surgery include:
- Over correction with consequent eversion of the lower
lid (this usually corrects itself within a few weeks)
- Infection
- Recurrence
Recurrence rates have improved dramatically with better understanding
of the abnormal muscles involved and better surgical techniques.
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