How Is Entropion Treated?

Entropion (an inward-turning eyelid) is most often treated with surgery, although some nonsurgical treatments may help temporarily, such as botulinum toxin injections.

Entropion is a condition in which the upper or lower eyelid turns inward and causes the eyelashes to rub against the cornea at the front of the eye. It can lead to eye irritation and sensitivity, and if not treated can result in decreased vision and corneal damage. 

Surgery to tighten any laxity of the eyelid and its attachments in order to restore the lid to its normal position is usually needed to treat entropion. Surgery is usually an outpatient procedure and can be performed under local anesthesia with or without sedation. 

Another treatment option for entropion for patients who are unable to have surgery is called the Quickert procedure, in which two or three strategically placed sutures are used to turn the eyelid in temporarily.

Nonsurgical treatments may be beneficial as temporary measures until surgery can be performed. Nonsurgical treatments for entropion may involve: 

• Botulinum toxin injections into the overactive eyelid squeeze the muscles to weaken them which can allow the eyelid to roll back into its natural position
• Taping of the lower lid to the middle of the cheekbone just underneath the lower eyelid (malar eminence) 
• Application of a type of adhesive liquid bandage to turn the lid margin outward 

In some cases, entropion is caused by another underlying condition such as: 

• Previous surgeries
• Burns
• Trauma
• Infection
• Inflammation
• Birth defects

In these cases, if the underlying condition is able to be treated, it may help treat the entropion. 

Symptoms of entropion include: 

• The turning in of the eyelids
• Eye irritation
• Eye redness 
• Tearing
• Eye discharge
• Crusting of the eyelid 
• Feeling as if something is in the eye
• Eye dryness
• Sensitivity to light and wind
• Pain
• In severe cases, or if untreated: 
  • Decreased vision 
  • Eye infections
  • Corneal abrasions
  • Corneal ulcers

Entropion is usually caused by muscle weakness due to aging. As we age, the muscles around the eyes tend to weaken, and the eyelid tendons tend to loosen. This can result in the eyelid turning in. 

Other causes of entropion may include: 

• Scar tissue pulling the eyelid out of position
• Eyelid spasms
• Forceful blinking
• Eye squeezing
• Neurological conditions that cause the eyelid to roll inward
• Trauma
• Previous surgery

• Entropion is diagnosed with a routine eye exam in which the doctor will examine the eyelids and surrounding tissue. 
• Eyelid laxity may be checked with a snap back test, in which the lower lid is pulled down and observed as it returns to its original position without allowing blinking. When there is increased laxity, a blink may be needed to put the eyelid back into proper position. 
• The cornea may be examined with a fluorescent dye to check for abrasions, corneal scarring or thinning, and new blood vessel formation in the cornea.