Entropion

Entropion is the tale of a protector who turns predator.

Eye-lashes and Eyelids:

 

 

Eyelashes perform the function of protection of the eye from debris and are sensitive to touch thanks to which the eye is reflexively shut when dust particles, sweat, insects or other foreign objects are near the eye.

Eye-lids keep your eyes moist by sweeping the secretions of the tear glands over the surface of the eye at frequent intervals. When you are sleeping they cover your eyes and help prevent your eye from drying out.

What is Entropion?

However, there are instances when these guardians turn against the very eyes they were supposed to shield. The edges of the eyelid (usually the lower) literally turn in so that the eyelashes rub against your eye surface. The eyelid may be turned inwards the entire time or it may turn in on blinking forcibly or tightly squeezing shut your eyelids.

What causes entropion?

So what is it that forces your eyelids to turn into a renegade?

1.Aging: The muscles surrounding the lower part of the eye become weak and their tendons relax causing the lid to turn inwards. Although all ages can be affected, entropion is seen primarily in the older age group. This is called involutional entropion.
2.Infections: Trachoma is a bacterial infection of the eye which causes scarring of the inner aspect of the lid leading to entropion. Herpes of the eye can also cause this. This usually affects the upper eye lid. This is the type which can affect cornea more.
3.Congenital: It may be present from birth due to defects in the muscles that retract the lower eyelids causing their laxity or weakness. However, this type is rare.
4.Scarring: A scar tissue formed on the conjunctiva (Thin membrane that covers the eyeball) due to injury, chemical burns, infections, local reaction to eye medications or   certain diseases. This type is called cicatricial entropion.
5.Spasm: The muscles under your eyes may go into a spasm (sudden involuntary contraction of muscle) causing the eyelids to turn inwards.  This can happen due to infection, trauma or temporarily after an eye surgery. This type is called spastic entropion.
 

Do I have Entropion? (Signs and Symptoms)

• Watery eyes.
• Decrease in vision due to damage to the cornea.
• Pain in the eyes or discomfort.
• Irritation of the eyes or sensation of a foreign body.
• Redness of the eyes.
• Sensitivity to light and wind.
  (Much more than tears of betrayal, nay?)

What are the complications?

• Corneal abrasions (Injury to the outer surface of the cornea like a scratch on the cornea)
• Corneal ulcers (An open sore on the cornea)
• Eye infections

If you have already been diagnosed with an entropion, keep a watch for rapidly increasing redness, sensitivity to light, pain or reducing vision. If any of these are experienced, seek urgent care.

What are the tests to be done?

Just a physical examination suffices to diagnose an entropion. Special tests are not required.
A snap test may be done by your doctor, where he /she gently pulls your eyelid forward and releases it so that it snaps back. From the reaction of your eyelids, your doctor can confirm an entropion.

What is the prognosis?

If corneal ulcer has not yet formed, the prognosis is quite good.
However if you leave it untreated, your cornea can get damaged enough to cause loss of vision.

How is it treated?

Lubricants or artificial tears may be prescribed by our doctor to keep the cornea moist.

When it is caused by an active infection, treatment of the same may cause the eyelid to return to its normal position.

Botox Injections into the eyelid to paralyse the eye muscles can stop it from turning inward. This can help you if your entropion is due to a temporary spasm after an eye surgery because the entropion will resolve itself before the Botox effects wear off.

Surgery may be required to correct the position of the eyelids: The eyelids are tightened surgically under local anaesthesia if muscle relaxation is the cause. If it is a scar tissue that is the culprit, a skin graft from the upper eyelid or behind the ear may be used.

Most patients report an immediate relief of their symptoms.

And thus your eyelids can get back to their jobs as custodians of your eyes.