Lawrence G. Kass M.D.

OCULOPLASTIC & FACIAL

COSMETIC SURGERY


727.522.3223

St. Petersburg / Clearwater

Entropion Repair Surgery

Entropion, or in-turning, of the eyelid can involve the upper or lower eyelid. Symptoms occur due to the scratching of the eye by the inwardly pointing eyelashes (trichiasis). Usually numerous eyelashes are involved, and it is impractical to pull all of them. This condition can occur due to generalized aging changing in the eyelid with a gradual rotation inward. Other cases are caused by scarring, either from trauma, infection, or an inflammatory condition such as shingles of the eyelid.


Entropion can cause irritation to the eyelid and the eye. This can result in excessive tearing, crusting of the eyelid and mucus discharge, a feeling that something is in the eye, irritation of the cornea and impaired vision. Damage to the cornea (the clear part of the eye that allows light to enter the eye), including infection and scarring, may develop due to the chronically turned-in eyelid.


These are important reasons for having this condition repaired before permanent damage occurs to the eye. The eyelids are meant to protect the eyes and to preserve vision, and they are unable to do so if there is entropion. The real concern for patients with entropion is loss of transparency of the cornea and subsequent loss of vision if the eyelid malposition is not corrected in a timely fashion.


Medical Management


In the case of acute spastic entropion, the treatment is directed to the provoking stimulus e.g. in growing eyelashes, blepharitis, dry eye. Although a bandage contact lens or botulinum toxin injections may improve symptoms temporarily, these are rarely justified. The use of lower lid tape can be advised for use in primary care while the patient is waiting to be seen by an oculo-facial specialist.



Treatment


While lubricating drops and ointments can provide temporary relief, eyelid surgery is usually necessary. The entropion repair procedure is usually performed as an outpatient (there is usually no need for hospitalization). Local anesthesia, which numbs the eyelid, is combining with light sedation so there is little, if any, pain during or even after the procedure.


The entropion repair procedure usually is performed as an outpatient (there is usually no need for hospitalization). Local anesthesia, which numbs the eyelid, is combining with light sedation so there is little, if any, pain during or even after the procedure.


Final Reminders


To effectively treat entropion requires a special understanding of the anatomy and pathophysiology of the eyelid. The excellent general plastic surgeon who does tummy tucks and breast augmentations almost NEVER has been trained in eyelid anatomy or pathophysiology and should NOT be the one you choose to treat your entropion, which should be treated only by a fully fellowship trained oculo-facial surgeon. Fellowship in the American Society of Oculo-facial Plastic and Reconstructive Surgery (ASOPRS) indicates that the surgeon has greatest specialized training and expertise in this subspecialty.


If you have entropion, please consult with Dr. Kass who is fully trained to treat this problem and has been in practice in St. Petersburg for over 27 years.