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.
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 7–10 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, botulinum toxin to the lower-lid muscle) can provide short-term relief but are rarely durable.