Entropion is an inward turning of the eyelid margin, usually the lower lid, so the lashes rub against the eye. It is most often age related, can also follow scarring from trachoma, chemical burns or inflammatory disease, and the constant rubbing can damage the cornea.
Key symptoms
- Feeling of something in the eye
- Redness, tearing and discharge
- Sensitivity to light
- Symptoms that come and go as the lid turns in and out
What you find on exam
- Lid margin and lashes turned toward the eye; a forced lid squeeze can reveal it
- Lid laxity
- Fluorescein: staining or abrasions on the lower cornea
- Look for scarring of the conjunctiva
Tests
- Clinical diagnosis
- Slit lamp with fluorescein to assess corneal damage
- Look for causes of scarring: trachoma, chemical injury, ocular pemphigoid
Treatment basics
- Lubricating drops and ointment
- Temporary: tape the lid outward or use a bandage contact lens
- Botulinum toxin injection as a temporary fix in selected patients
- Surgery to tighten and turn out the lid is the definitive treatment
- Treat corneal abrasions or infection with antibiotic ointment
Red flags
- White spot on the cornea (ulcer)
- Decreasing vision
- Severe pain or light sensitivity
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.