Entropion – Diagnosis and Treatment

Diagnosis

Doctors often use a basic eye exam to check for entropion. They might gently pull on the lower eyelids or ask patients to blink or squeeze their eyes shut.

This helps them watch how the eyelids move and see if the edge of the eyelid turns inward.

They look for signs like irritation, redness, pain, excessive tearing, or swelling. If scar tissue, past injuries, tumors, or swelling appear near the eyelids, doctors closely examine these areas to find any other causes.

The main goal is to spot symptoms like discomfort, watery eyes, or issues that could harm the cornea.

Common things checked during diagnosis:

Sign/Symptom	What It Means
Redness	Possible ongoing irritation
Pain	May suggest corneal damage
Tearing (Watery Eyes)	Sign of eyelid misalignment
Swelling	Could hint at trauma or disease
Discharge	Can point to infection

Doctors also consider other possible factors, such as thyroid eye disease or aging, if the eyelid changes are not linked to simple trauma.

Treatment

Nonsurgical Options

Several nonsurgical methods can help relieve discomfort and protect the eye until surgery becomes an option. Wearing a soft contact lens may serve as a temporary corneal shield.

These lenses, available with or without a prescription, help reduce irritation caused by the misaligned eyelid rubbing against the eye.

Doctors may inject a botulinum toxin type A preparation into the lower eyelid to relax the muscles and help the eyelid turn outward. The effects typically last up to six months, and repeated treatments may be necessary.

Eye doctors or oculoplastic surgeons can place eyelid-rotating stitches using local anesthesia. After numbing the eyelid, the doctor inserts several stitches, which rotate the eyelid out so it points in the proper direction.

As the eyelid heals, scar tissue forms and can keep the eyelid properly placed for several months. This technique is a short-term measure, as the eyelid may eventually roll back in.

Applying special skin tape to the eyelid holds it in place and stops the lashes from rubbing against the eye.

Summary Table: Nonsurgical Treatments

Method	Purpose	Duration
Soft contact lens	Protects the eye	Until further treatment
Botox injections	Turns eyelid outward temporarily	Up to 6 months
Rotating stitches	Rotates eyelid by using sutures	Several months
Skin tape	Holds eyelid in place externally	Short-term

Corrective Eyelid Surgery

Surgeons typically use surgery as the main treatment for fixing entropion, especially if nonsurgical steps do not give lasting relief.

The surgery type depends on the underlying cause—whether loosened muscles, weakened tendons, or scar tissue from injury, past surgery, or infection are involved.

Most often, the oculoplastic surgeon removes a small segment of the lower eyelid to pull the eyelid tight and ensure it rests against the eye correctly.

The surgeon closes the incision with sutures to hold the new shape. These stitches are usually removed about a week after the operation. If scar tissue is present inside the eyelid, the doctor may perform a mucous membrane graft.

The graft tissue usually comes from the roof of the patient’s mouth or their nasal area. This procedure replaces stiff or damaged inner eyelid tissue.

Surgery for the eyelid is often performed as an outpatient procedure under local anesthesia. Sometimes, doctors provide mild sedation for extra comfort.

Swelling and bruising commonly occur after surgery but usually go away within two weeks. Doctors often prescribe an antibiotic ointment for the first week after the operation, and patients may need to use cold compresses to limit swelling.

Key Points:

• Surgery offers a long-term solution for entropion.
• The technique depends on the type and cause of eyelid damage.
• An oculoplastic surgeon performs these repairs, sometimes using reconstructive techniques for difficult cases.
• Post-surgery care includes medications and follow-up visits to monitor healing.

At-Home Care and Lifestyle Tips

People with entropion can try simple steps at home to reduce discomfort. Artificial tear drops help keep the eyes moist and protect against dryness. Applying eye ointments—especially before bed—can further shield the eye and ease irritation.

A list of helpful actions:

• Use artificial tear drops during the day.
• Apply eye ointment at night.
• Ask a doctor about clear skin tape to gently hold the eyelid in place.

If a doctor prescribes an antibiotic ointment, use it as directed to lower the risk of infection.

Getting Ready for Your Visit

Steps You Can Take Beforehand

To help make your appointment more productive, prepare in advance.
Bring a list of:

• Medicines and Supplements: Write down all medications, vitamins, and supplements you use with the correct doses.
• Symptoms: List the specific problems you’ve noticed and when each one started.
• Medical History: Note any other eye issues, surgeries, or injuries you’ve had before.
• Questions for the Doctor: Prepare important questions.

Sample questions to consider asking:

Question	Purpose
What could be causing my symptoms?	To learn about the reason behind the problem.
What tests will I need?	To know if you must prepare for any exams.
Is this a short-term or long-term issue?	To understand how long entropion might last.
Can this harm my eyesight?	To see if your vision is at risk.
What treatments do you recommend?	To review possible treatment options.
Are there any risks with surgery?	To go over surgery safety.
Can I avoid surgery?	To learn about other treatment choices.
How will my other health problems affect this?	To manage all health conditions together.

Bringing notes and questions helps you remember the things that matter most.

What the Doctor Might Ask

At your visit, the doctor will likely ask some questions to better understand your condition:

• When did your symptoms begin?
• Have they been steady or come and go?
• Have you had any eye procedures or surgeries before?
• Any history of eye injuries or infections?
• Are you currently using blood thinners or medications like aspirin?
• Do you use any eye drops?