Entropion of the upper eyelid is a medical condition where the eyelid margin, along with its eyelashes, turns inward towards the surface of the eye. This inward turning causes the eyelashes and skin to rub against the eyeball, leading to irritation and discomfort.
Understanding Upper Eyelid Entropion
The eyelids normally function to protect the eye, distribute tears, and help keep the eye moist and clean. In upper eyelid entropion, this normal function is disrupted as the eyelid folds inward, causing the eyelashes to scrape against the cornea, the clear front part of the eye.
The primary causes of upper eyelid entropion differ from those of the lower eyelid. Unlike lower eyelid entropion, which is most often age-related, upper eyelid entropion is frequently caused by conditions that lead to shrinkage of the back surface of the eyelid. This can include eye infections such as trachoma, which causes scarring of the eyelid.
Other factors contributing to upper eyelid entropion include previous trauma or surgery to the eyelid, which can alter its shape. Inflammatory diseases like cicatricial pemphigoid, causing inflammation of the inner eyelids, can also lead to this inward turning. Muscle spasm or congenital factors may also cause upper eyelid entropion.
Recognizing the Signs and Potential Concerns
Individuals with upper eyelid entropion often experience a range of uncomfortable symptoms due to the constant rubbing of eyelashes against the eye. Common signs include eye irritation, a gritty feeling, excessive tearing, and redness of the eye. Light sensitivity and eye pain are also frequently reported.
If left unaddressed, upper eyelid entropion can lead to significant complications. The continuous friction from the eyelashes can cause corneal abrasions, which are scratches on the surface of the eye. These abrasions can progress to corneal ulcers, which are open sores on the cornea. Corneal ulcers can cause blurred vision, increased pain, and severe watering, and if untreated, they carry a risk of eye infections and potentially permanent vision loss.
Available Treatment Options
Diagnosis of entropion typically involves a thorough eye examination by a healthcare provider. Initial management often focuses on temporary relief and protecting the eye from irritation. Lubricating eye drops and ointments can provide moisture and help reduce discomfort, though they are not a long-term solution.
Soft contact lenses may be recommended to act as a bandage, offering a protective barrier for the eye surface. Botulinum toxin injections into the eyelid muscles can temporarily relax them and help reposition the eyelid. Taping the eyelid to the cheek can also offer a temporary way to turn the eyelid outward.
For a definitive and lasting correction, surgery is typically required. Surgical techniques for upper eyelid entropion often involve an incision in the horizontal skin crease of the lid. During the procedure, the muscle that pulls the eyelid upwards may be adjusted, and absorbable sutures are strategically placed to evert, or turn outward, the eyelid margin. For cases caused by scarring, the surgery might involve repositioning the eyelashes or using grafts to restore the eyelid’s proper structure.
Life After Treatment
Following upper eyelid entropion surgery, patients can expect some common post-operative effects, including temporary swelling and bruising around the eye. These symptoms are a normal part of the healing process and typically subside within about two weeks.
Patients are usually instructed to instill antibiotic eye drops along with an ointment at bedtime for about two weeks to prevent infection. It is generally advised to avoid rubbing or touching the treated eyelid and to refrain from swimming for two to three weeks. A follow-up appointment is typically scheduled within about two weeks to monitor healing and check the eye’s surface and vision. The success rate of surgical correction is generally high, effectively alleviating symptoms and preventing further complications.