Entropion and ectropion
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What are entropion and ectropion?
These are two apparently opposite conditions - but both occur when the eyelid margin loses its correct position and stops performing its protective role.
In ectropion, the free margin of the eyelid (usually the lower lid) turns outward. The inner side of the eyelid remains exposed, the eyelid no longer rests against the surface of the eye, and the "tear pump" no longer functions normally.
In entropion, the free margin of the eyelid turns inward - towards the eye - together with the lashes and part of the eyelid skin. The lashes then constantly touch and irritate the surface of the eye.
Both conditions most commonly occur on the lower eyelid and usually as a result of the natural weakening of eyelid tissue with age.
How are they recognised?
Ectropion - symptoms:
Increased tearing (tears run down the cheek as they are not drained normally)
Discomfort and eye irritation
Dryness and redness of the inner eyelid surface
Visibly "turned out" margin of the lower eyelid
Entropion - symptoms:
Constant eye irritation - a feeling of something "scratching" or "stabbing"
Redness and increased tearing
Sensitivity to light
In advanced cases: damage to the corneal epithelium, ulceration, and in severe cases corneal perforation
Both conditions are progressive and will not resolve on their own. Entropion in particular can lead to serious damage to the eye surface - prompt examination is important.
How do they develop?
Both conditions can develop for various reasons:
Age-related changes - weakening of eyelid tissue with age - the most common cause
Scarring - as a result of injury, burns, or other conditions
Spastic, mechanical, or congenital changes
Ectropion can also be a consequence of facial nerve palsy
How are they treated?
Treatment of both conditions is most commonly surgical - the choice of appropriate method depends on the cause that led to the change in eyelid position. The procedure is performed under local anaesthesia, on an outpatient basis. Using the principle of horizontal shortening and repositioning of the eyelid, the margin is returned to its normal position and proper protective function is restored.
Frequently asked questions
Is there a temporary measure while waiting for surgery?
Yes. In ectropion, adhesive tape is sometimes used temporarily to hold the eyelid in the correct position. In entropion, special therapeutic contact lenses can be used to protect the eye surface from irritation by the lashes. These measures are temporary - the permanent solution is surgical intervention.
Does surgery leave visible scars on the eyelid?
The incision is placed so as to be as inconspicuous as possible - usually in the natural fold of the eyelid. In most patients, after healing, the trace of the procedure is minimal or invisible.
Do not put up with discomfort due to eyelid position.
Entropion and ectropion are successfully treated with a short surgical procedure under local anaesthesia - schedule an examination.