Understanding Entropion and its Impact
Entropion is a condition where an eyelid, most commonly the lower one, turns inward, causing the eyelashes and skin to rub against the surface of the eye. This constant friction can lead to significant discomfort and potential damage to the eye’s delicate structures.
Aging is a primary cause of entropion as the muscles and tendons around the eye naturally weaken and stretch over time. Other contributing factors include scarring from previous injuries or surgeries, which can alter the eyelid’s shape. Eye infections, such as trachoma, can also lead to scarring of the inner eyelid and subsequent entropion. Congenital factors, like incomplete muscle formation, can cause entropion from birth.
The inward-turning eyelid causes irritating symptoms. Individuals often experience a feeling that something is in their eye, along with redness, eye pain, and irritation. Sensitivity to light and wind, excessive tearing, and mucous discharge with eyelid crusting are common. Without correction, the continuous rubbing of eyelashes against the cornea can result in abrasions, infections, and corneal ulcers. These issues can progressively impair vision and, if left unaddressed, may lead to permanent eye damage or even vision loss.
The Surgical Process
Entropion surgery is an outpatient procedure. It is performed under local anesthesia, which numbs the eyelid and surrounding areas. The main objective of the surgery is to reposition the eyelid so it turns outward, preventing the eyelashes from rubbing against the eye.
Several surgical techniques exist, chosen based on the specific cause and severity of the entropion. One common approach involves tightening the muscles and tendons that support the eyelid, such as through a lateral tarsal strip procedure, which shortens and tightens the eyelid at its outer corner. Another technique focuses on reinserting or advancing the lower eyelid retractors, muscles responsible for eyelid movement, to restore proper tension and position. Some procedures may also involve removing a small amount of skin or muscle to help evert the eyelid.
These procedures aim to restore the eyelid’s natural alignment, protecting the eye. The surgery takes about 30 to 45 minutes to complete. Immediately after the operation, a bandage or eye pad may be placed on the eye to minimize bleeding and protect the area. Patients might experience some initial discomfort, which can be managed with prescribed medication.
Pre-Surgical Preparation and Post-Surgical Care
Preparation for entropion surgery includes instructions to ensure a smooth procedure and recovery. Patients may be advised to discontinue certain medications, such as blood thinners or non-steroidal anti-inflammatory drugs (NSAIDs), for about two weeks prior to surgery to reduce the risk of excessive bleeding. It is also important to arrange for transportation home and for someone to assist for at least 24 hours after the procedure, as vision may be blurry and driving will not be permitted.
After surgery, swelling, bruising, and mild discomfort are common around the treated eye. Applying cool compresses for the first 48 hours can help alleviate these symptoms. Patients will receive antibiotic ointment to apply to the incision sites for about two weeks to prevent infection. Gently cleaning the eyelids with a sterile saline solution or cooled boiled water is also part of the post-operative care.
Activity restrictions are necessary during the initial recovery period. Patients should avoid strenuous activities, heavy lifting, bending, and swimming for at least two weeks to prevent complications. Rubbing or pressing on the eyelids should be avoided for several weeks. Stitches, if not dissolvable, are removed about one to two weeks after surgery. While significant bruising and swelling subside within two to three weeks, complete healing can take up to four months.