Entropion is when the eyelid — usually the lower lid — rolls inward so the eyelashes scrape against the eyeball. It causes a painful, gritty, watery and red eye, and if left untreated the rubbing lashes can scratch and scar the cornea. It is most often age-related, and the definitive treatment is a short day-case operation under local anaesthetic to turn the lid back to its normal position — from £2,400 per eyelid.
What is entropion?
In entropion, the eyelid margin turns inward toward the eye, so the lashes and lid skin rub against the cornea and conjunctiva with every blink. This constant friction (sometimes called trichiasis when only the lashes are misdirected) is uncomfortable and can damage the eye’s surface.
Entropion usually affects the lower lid and is most commonly involutional — caused by age-related weakening and slippage of the eyelid muscles. Other forms include cicatricial entropion, where scarring of the inner lid (from conditions such as trachoma, chemical burns or ocular pemphigoid) pulls the lid inward, and rare congenital cases. It is the opposite of ectropion, where the lid turns outward.
Symptoms of entropion
Because the lashes are constantly rubbing the eye, entropion causes persistent and often distressing symptoms:
- A feeling that something is in the eye (foreign-body sensation)
- Redness and pain around the eye and lid
- Watering and increased sensitivity to light
- A gritty, scratchy sensation with every blink
- Mucous discharge and crusting
If the cornea becomes scratched, the eye can become very painful and vision may blur — this needs prompt assessment to prevent lasting damage.
Lashes rubbing and a constantly sore eye? An oculoplastic assessment confirms entropion and whether a simple day-case repair will resolve it.
Book an eyelid assessmentCauses & risk factors
Entropion develops when the balance of forces holding the eyelid in position is disturbed. Common causes and risks include:
- Ageing — weakening of the eyelid muscles and tendons is the most common cause
- Eyelid spasm — repeated forceful blinking or squeezing can roll the lid inward
- Scarring of the inner eyelid — from infection (such as trachoma), chemical burns, trauma or inflammatory disease
- Previous eye surgery or injury
- Chronic eye inflammation that irritates the lid
How entropion is diagnosed
Entropion is diagnosed by a clinical examination with an oculoplastic surgeon, who also checks for any damage to the eye surface:
- Eyelid examination — assesses the position of the lid and lashes against the eye.
- Lid laxity tests — the snap-back and distraction tests gauge how slack the eyelid has become.
- Fluorescein staining — a harmless orange dye highlights any scratches or abrasions on the cornea.
- Slit-lamp examination — a magnified view of the lid margin, lashes and cornea.
- Cause assessment — identifies any scarring (cicatricial) cause that changes the surgical plan.
Treatment options
Temporary measures relieve symptoms, but surgery is the only lasting cure — see our entropion treatment overview for full detail.
- Lubricating drops and ointment — protect the cornea and ease irritation while you await surgery.
- Lid taping or everting sutures — temporarily hold the lid in the correct position; useful as a short-term measure.
- Botulinum toxin — can settle spastic entropion for a few months.
- Corrective surgery — a day-case procedure under local anaesthetic that tightens the lid and re-attaches the muscles (retractors) so it sits correctly. For scarring entropion, your oculoplastic surgeon may add a graft. A dedicated entropion eyelid surgery service is available.