An entropion is the medical term for a Einwärtskehrung the eyelid. As a result, the eyelashes drag steadily on the eye. Usually the lower eyelid is affected by the entropion.
What is an entropion?
According to DICTIONARYFORALL, an entropion is a malposition of the eyelid. The eyelid is turned inwards. Because of this inward turning of the eyelid, the eyelashes always drag on the cornea as well as on the conjunctiva. The acquired or congenital disease can be divided into four different forms: age-related entropion, scar entropion, congenital entropion and eyelid spasm.
The typical symptoms are the edge of the eyelid turned inwards and the eyelashes rubbing. The constant chafing causes other side effects such as reddened and occasionally, sometimes purulent-slimy, sticky eyes. As a result, those affected often squint, which increases the irritation and the resulting discomfort.
If the entropion persists for a long time, it can lead to scarring, ulcers and inflammation, which in turn have a negative effect on the visual acuity of the diseased eye.
Causes
There are many reasons for an entropion. Usually there is a disproportion in the pulling force of different eyelid muscles. This disturbed relationship mainly occurs with increasing age.
Scars on the eyelid conjunctiva can also cause entropion. In this case, the disease is often accompanied by bacterial inflammation of the eye. In addition to the acquired reasons for this inward inversion of the eyelid, there are also congenital eyelid malpositions. This usually occurs when the infant’s eye is too small or the hanging device on the lower eyelid is not sufficiently developed.
A so-called eyelid cramp can also cause this disease in the eye. In this case, the fibers of the ring-shaped eyelid muscle near the eyelid are constantly contracted. This condition causes a temporary entropion or can increase an already existing entropion.
Symptoms, ailments & signs
An inward turn of the eyelid leads to various unpleasant complaints in the eyes of the person concerned. As a rule, however, this disease can be treated well so that it does not lead to particular complications or serious complaints. Those affected primarily suffer from the edge of the eyelid that is bent inwards.
This leads to a permanent feeling of foreign bodies in the eye, which can have a very negative effect on the patient’s quality of life. Also, more eyelashes enter the eye, which can lead to pain or watery eyes. Also itching occurs and can therefore lead to bloodshot eyes.
If the inward curvature of the eyelid is not treated, the symptoms can permanently damage the eye, which can lead to various visual problems or even visual disturbances. In some cases, treatment of this complaint is not even necessary, as self-healing is very common. Furthermore, turning the eyelid inward can also have a negative effect on the aesthetics of the person concerned.
This can eventually lead to depression or various other psychological upsets. The life expectancy of the person affected is not negatively influenced by the inward turning of the eyelid.
Diagnosis
The conspicuous position of the eyelid usually enables a very quick diagnosis of entropion. The edge of the diseased eyelid is turned inwards so that the eyelashes constantly rub against the eye.
In addition to the simple visual diagnosis, a so-called slit lamp can be used for diagnosis. This instrument enables the ophthalmologist to determine the extent of the inversion on the eye. If the attending physician was able to identify the disease at an early stage, a favorable course is likely.
If the cause is congenital, the misalignment often resolves on its own. If the inversion is more pronounced or already chronic, it can be permanently corrected with consistent treatment methods. The misalignment rarely occurs again after an operation. If the entropion is not treated, vision may be impaired or the affected eye may be blind.
Complications
In most cases, the patient experiences an uncomfortable foreign body sensation on the eye due to the inward tilt of the eyelid. This feeling of a foreign body often leads to the victim reaching into his eyes with his fingers and rubbing them. This can lead to infections and inflammation, which can lead to consequential damage and other diseases.
The eyes are also reddened and can also water. The symptoms limit the quality of life and in many cases the patient can no longer concentrate. It is also no longer possible to carry out different work and activities without further ado. Early treatment is possible because the diagnosis is relatively simple and straightforward.
The further course of the inward turning of the eyelid also depends heavily on the cause of the symptom. In most cases, no surgery is necessary. However, if the inflammation is severe, surgery is necessary. The patient is also dependent on eye drops or ointments to support the treatment. Turning the eyelid inward does not reduce life expectancy.
When should you go to the doctor?
If the edge of the eyelid is turned inwards, it is likely an entropion. A doctor’s visit is required if the eye-catching position of the eyelid has not receded after one or two days at the latest. If there are other symptoms and the conjunctiva is severely irritated, for example, a specialist must be consulted on the same day. The same applies if the disease is accompanied by bacterial eye inflammation or has a serious cause.
Entropion that occurs after an eyelid spasm must be examined and treated immediately, otherwise further complications can arise. You should also see an ophthalmologist with congenital or chronic malpositions. If the symptoms are severe, it is best to go to the nearest hospital or a specialist ophthalmological clinic.
Children, the elderly and the sick should definitely visit the ophthalmologist’s practice immediately because of possible secondary symptoms. Depending on how severe the entropion is, longer-term medical supervision is necessary.
Treatment & Therapy
The treatment method for an entropion depends crucially on the extent of the misalignment of the eyelid. Furthermore, the cause of the inward turn is decisive. If it is a matter of slight entropion, which has arisen, for example, from an inflammation, a strip of adhesive plaster attached to the lower eyelid is often sufficient as a form of therapy.
Alternatively, the eyelid can be fixed with a Schöpfer suture. If the inward turn is more pronounced or chronic, surgical intervention may be necessary. The eyelid is shortened and excess muscle is removed. If the condition of the sick eye does not improve despite various treatments, a therapeutic contact lens can prove to be helpful. The artificial lens keeps the eyelashes away from the cornea and thus prevents the eyes from becoming severely irritated.
In order to treat the possible changes in the cornea by inverting the eyelid, it may be necessary to apply eye ointments. If the misalignment is congenital, no special therapy is usually necessary. The eyelashes in babies are still very soft, so no damage to the cornea is to be expected. Congenital entropion often decreases within the first two years of life without treatment.
Outlook & forecast
In old age there can be entropion, an inward turning of the eyelid. However, this phenomenon can also be innate. In this case it often regresses on its own. It is different with an entropion that arose later. The operation often has to be performed under local anesthesia. The problem with this is that the success of the operation can only last longer if treated early. In this way, entropion recurrences can often be prevented.
Relapse often occurs some time after a successful operation. The eyelid is turned inwards again. This causes considerable discomfort. A relapse worsens the chances of finding permanent relief from the symptoms. The prognosis is good only with congenital inward curvatures of the eyelid and with early surgery.
The reason for the poor prognosis lies in the operation itself. The entropion operation is relatively complex. It involves a horizontal shortening of the affected eyelid. For this, parts of the eyelid skin and the muscles that move it have to be removed below the eye. This operation helps against the inward curvature of the eyelid. At the same time, it weakens the ring-shaped sphincter that the lid protects the eye. Because of this, the prognosis for a relapse worsens. Another operation weakens the sphincter further.
Prevention
There are no preventive measures for entropion or an inward turning of the eyelid. One can only try to avoid infection and injury to the eyes. The resulting scars could otherwise lead to a scar entropion. Since entropion can also be innate, preventive measures are severely limited.
Aftercare
When the eyelid is turned inward, in most cases there are no special follow-up options available to the affected person. The person concerned is primarily dependent on the medical treatment of this complaint in order to prevent further complications. Since it cannot heal itself, immediate and quick treatment is usually also useful in order to avoid further complaints.
The earlier a doctor is consulted when the eyelid is turned inward, the better the prognosis for this disease. In most cases, the exact type of treatment depends on the exact complaints and their severity. In some cases, surgical interventions are also necessary to alleviate these symptoms. After such a surgical procedure, the person affected should always rest and take care of their body.
Exertion or other stressful and unnecessary activities should be avoided in any case. In some cases, ointments can also be helpful, although those affected should ensure that they are applied regularly. The life expectancy of the patient is in most cases not reduced by this disease. Wearing contact lenses can also help to limit the symptoms.
You can do that yourself
Self-help measures for this eyelid malposition are possible to a limited extent and should be implemented in consultation with the attending physician.
In the case of reddened eyes, those affected should refrain from using cosmetic articles in the eye region. If there is a need to hide the visual flaw of the deformity with natural aids, it is advisable to use glasses with window glass. Ensure that there is sufficient tear fluid. If the eyes are too dry, eye drops should be used.
Itching and chafing of the eyes should generally be rented out. Otherwise pathogens can get into the organism through the vacancies and trigger further diseases.
In order to deal with the disease emotionally and spiritually, the person affected often needs measures to strengthen their self-esteem. Situations can be created in which a sense of achievement is built up. The patient should concentrate on his strengths so that entropion does not become the center of his life.
In addition, an open approach to the disease and its complaints helps. In the offensive manner, the misalignment is less noticeable by outsiders. Relaxation techniques also help to achieve inner serenity and reduce stress in everyday life.
