Entropion
👁️ Entropion
🔍 Definition
Entropion is a condition where the eyelid margin turns inward, causing the eyelashes and skin to rub against the surface of the eye (cornea and conjunctiva). It most commonly affects the lower eyelid.
🧬 Types of Entropion
| Type | Cause | Common Age Group |
|---|---|---|
| Involutional | Age-related degeneration of eyelid tissues | Elderly |
| Cicatricial | Scarring of the conjunctiva causing lid to turn in | Any age (often due to injury or disease) |
| Spastic | Eyelid muscle spasm, often due to irritation or inflammation | All ages |
| Congenital | Rare; due to improper development of eyelid structures | Infants |
🧠 Etiology (Causes)
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Aging (most common): weakened lower eyelid retractors
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Chronic eye inflammation: e.g., trachoma, Stevens-Johnson syndrome
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Chemical burns
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Trauma or surgery causing conjunctival scarring
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Infections: trachoma, herpes zoster ophthalmicus
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Congenital malformation
👀 Clinical Features
| Symptom / Sign | Description |
|---|---|
| Foreign body sensation | Due to lashes rubbing against cornea |
| Redness & tearing | Reflex tearing and irritation |
| Photophobia | Sensitivity to light due to corneal irritation |
| Blurred vision | If cornea becomes damaged |
| Trichiasis | Inward turning of eyelashes |
| Conjunctival injection | Redness due to irritation |
| Corneal erosions/ulcers | May occur in advanced cases |
🔍 Diagnosis
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Clinical exam – observe lid position and lashes
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Fluorescein stain – detects corneal epithelial defects
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Snap-back & distraction tests – assess eyelid laxity
💊 Treatment
🔹 Conservative (temporary)
| Method | When Used |
|---|---|
| Lubricating drops | To protect cornea |
| Eyelid taping | Temporarily turns lid outward |
| Botulinum toxin injection | Into orbicularis to relax muscles |
| Bandage contact lens | Protects the cornea |
🔹 Surgical (definitive)
| Procedure | Type of Entropion |
|---|---|
| Lid tightening procedures | Involutional |
| Everting sutures (Quickert sutures) | Involutional / temporary correction |
| Mucous membrane grafting | Cicatricial |
| Scar release with skin graft | Cicatricial |
| Lower lid retractor reinsertion | Involutional |
⚠️ Complications
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Corneal abrasions
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Recurrent eye infections
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Corneal ulceration → scarring → vision loss
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Chronic conjunctivitis
📋 Quick Comparison: Entropion vs Ectropion
| Feature | Entropion | Ectropion |
|---|---|---|
| Lid direction | Inward (lashes rub eye) | Outward (lid turns out) |
| Irritation | From lashes on cornea | From exposure of conjunctiva |
| Common age group | Elderly | Elderly |
| Treatment | Lubricants → surgery | Lubricants → surgery |
🧠 Mnemonic: “EN = In” (Entropion = eyelid turns in)
Would you like:
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A diagram showing the difference between entropion & ectropion?
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A summary flashcard version?
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Or details on surgical techniques?
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