Entropion – an in-turning eyelid
In entropion the lid margin – usually the lower one – rolls inwards. The lashes rub against the surface of the eye with every blink. Patients describe a constant feeling of sand in the eye.
Symptoms
- foreign-body sensation, scratching and burning,
- watering, a red eye, sensitivity to light,
- mucous discharge, recurrent irritation,
- in advanced cases – corneal abrasions and ulcers, reduced vision.
Causes
The most common is involutional entropion, related to age: loosening of the lid ligaments and weakening of the muscles. Less often it is caused by conjunctival scarring (after burns, injuries, chronic inflammation) or spasm of the orbicularis muscle.
Ectropion – an out-turning eyelid
In ectropion the lower lid margin pulls away from the eye. The exposed conjunctiva dries out and reddens, and tears no longer reach the tear duct opening, so they run down the cheek.
Symptoms
- chronic watering, constantly wiping tears,
- redness and thickening of the exposed conjunctiva,
- dryness, burning, irritation,
- irritated skin under the eye from constant tears.
Causes
Ectropion most often results from age-related lid laxity. It can also follow facial nerve palsy, skin scarring (after injuries, burns, skin treatments or previous eyelid surgery) or a tumour weighing the lid down.
Treatment
Lubricating drops, ointments or taping can relieve symptoms temporarily but do not address the cause. In most cases the lasting solution is surgery, chosen according to the mechanism:
- lateral tarsal strip – shortening and re-anchoring the lax lid at the outer corner; the core procedure for age-related entropion and ectropion,
- everting sutures or lower-lid retractor repair – in entropion, to restore the correct lid margin position,
- medial correction – when the out-turning affects the area of the tear duct opening,
- scar release and skin graft – in cicatricial ectropion, when skin is lacking.
Surgery is usually done under local anaesthesia and most often takes 30 to 60 minutes per lid.
Healing
For the first days the lid is swollen and the outer corner may feel tight – an intended effect that eases over time. Skin stitches are removed after about 7 days. Symptoms from rubbing lashes usually settle quickly; watering from ectropion improves gradually over weeks.
Why not wait?
Chronic rubbing of the cornea by lashes (entropion) or its drying (ectropion) increases the risk of infection, ulcers and permanent corneal scarring. Early surgery is usually simpler and recovery faster. If you recognise these symptoms, book a consultation.
Frequently asked questions
Does plucking the lashes help with entropion?
Only briefly – lashes grow back, often stiffer and more irritating. It also does not fix the cause, which is the incorrect lid position.
Can the problem come back after surgery?
Recurrence is possible, especially as tissues continue to loosen with age, but it is uncommon with a well-chosen technique.
Can the upper eyelid be affected?
Entropion and ectropion most often affect the lower lid. Upper-lid cases are rarer and usually have a different cause – they need individual assessment.
This page is for information only and does not replace a medical consultation. Eligibility for any procedure is decided by the doctor after an examination.
