Entropion

Definition/diagnostic criteria Entropion is an ocular condition characterised by the inward turning (inversion) of the eyelid margin. This results in eyelashes and skin rubbing against the cornea and conjunctiva, leading to discomfort and potential ocular damage. The condition is typically classified into two main types: involutional (age-related) and cicatricial (due to scarring).

Epidemiology Entropion predominantly affects the elderly, with a higher incidence in those over 60 years of age. Involutional entropion is the most common type, linked to age-related changes in eyelid tissue. Cicatricial entropion, though less common, is associated with ocular scarring due to infections, trauma or autoimmune conditions.

Diagnosis
Clinical features: Patients usually present with symptoms of eye irritation, tearing and photophobia. On examination, the inward turning of the eyelid is evident. Complications such as corneal abrasion or infection may be present due to continual eyelash rubbing.

Investigations: Diagnosis is primarily clinical. In cases of cicatricial entropion, identifying the underlying cause is crucial.

Treatment Treatment options vary based on the type and severity of entropion.

  • Non-surgical management: For temporary relief, taping the eyelid in an outward position or using lubricating eye drops and ointments can be effective. Botulinum toxin injections are another non-surgical option for temporary correction, particularly in patients unfit for surgery.
  • Surgical management: Surgery is the definitive treatment for entropion. Techniques vary, but they generally aim to correct the eyelid malposition and address underlying causes, such as laxity or scarring. Involutional entropion may require procedures like lid tightening or retractor reinsertion, while cicatricial entropion may need scar revision and grafts.

Prognosis The prognosis for entropion is generally good, especially when treated promptly. Surgical outcomes are typically successful, with low recurrence rates. However, untreated entropion can lead to chronic irritation, infection, and potentially serious corneal damage.

Further reading

  • Royal College of Ophthalmology.
  • ChatGPT has assisted in the creation of this content which has been then thoroughly reviewed by our GP advisors to ensure its timeliness and reliability.

Published: 31st July 2022 Updated: 16th February 2024

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Nursing in Practice Reference is based on the best-selling book Symptom Sorter. The experts behind Nursing in Practice Reference are Marilyn Eveleigh who is Nursing in Practice’s editorial advisor and a primary care nurse in East Sussex, Dr Keith Hopcroft who is the co-author of Symptom Sorter, a GP in Essex and Pulse editorial advisor and Dr Poppy Freeman, a GP in Camden and also a clinical advisor to Pulse.