Summary
In entropion, the lower eyelid rolls inwards so the lashes rub against the cornea. This causes a gritty, watering, red eye that often feels worse first thing in the morning. Untreated, the constant rubbing can scratch the cornea and threaten vision.
Who is this for?
Most entropion is age-related (involutional), where the supports of the lower lid have loosened. Other types include cicatricial entropion (scarring on the inside of the eyelid) and, rarely, congenital entropion. Typical symptoms are:
- a constantly red, watering eye,
- a sensation of something in the eye, especially on waking,
- blurring of vision from corneal abrasion.
Is this funded on the NHS?
This is the eyelid operation with the cleanest answer in Hampshire. Policy 53 funds entropion repair when an ophthalmologist judges it appropriate, with no duration to wait out, no course of conservative treatment to fail first and no test to pass. The policy sets out its reasoning: lashes turned in against the cornea can threaten sight. An earlier edition did impose a waiting period, and it was removed in 2022 for exactly that reason. It is worth appreciating that this is not how the same board treats ectropion, which is gated on two months of symptoms, even though the two conditions share one policy document; fourteen boards across England draw a distinction of some kind between them. Tightening the lid for cosmetic reasons alone is not funded, and the North East Hampshire locality does apply criteria where the rest of the county does not. How the thirty-six boards compare on this operation is set out separately.
What the procedure involves
The exact procedure depends on the cause. Most patients with age-related entropion are best treated with a lower-lid tightening procedure with retractor reinsertion: a 30-minute day-case operation through a small incision just below the eyelashes, performed under local anaesthetic.
For frail patients or as a quick interim measure, everting sutures (a ‘Quickert’ procedure) take just 15 minutes and provide good short-term relief.
Recovery and what to expect
- Mild bruising and swelling for 7 to 10 days.
- Sutures absorb on their own or are removed at around a week.
- Most patients notice an immediate improvement in the gritty sensation.
- Antibiotic ointment is used for a week.
Risks and alternatives
Risks include under- or over-correction, asymmetry, lower-lid retraction (the lid sitting slightly low), infection and recurrence. Recurrence rates after a definitive procedure are under 10%.
Non-surgical options (taping the eyelid, a temporary eye-lubricating regime, anti-spasm injections to the lower-lid muscle) can provide short-term relief but are rarely durable.