What is it?
Entropion is condition in which an eyelid’s rim (usually of a lower lid) is turned inward towards the direction of the eyeball. A consequence of the entropion is the continuous irritation of the conjunctiva and cornea by improperly positioned eyelashes, eye pain, inflammation, excessive tearing and deterioration of visual acuity. Long-term entropion leads to corneal ulceration and degenerative changes.
Causes
The most common reason is ageing of the eye, which causes ligaments laxity and orbicularis oculi anterior movement. Less frequently occurring cause include scarring after trauma, burns or surgical procedure. Eyelid entropion may also be congenital and constitute a developmental defect.
Treatment
Treatment is carried out by performing surgery. Qualification for surgery involves assessing the degree of the eyelid entropion and evaluation of the eyelid ligaments laxity. On this basis, the decision on the mean of correction is undertaken.
Acute symptoms associated with direct irritation of the eyeball’s surface by lashes can be alleviated until the treatment by using appropriate eye medical ointments, moisturisers and protective medications or/and by wearing therapeutic contact lenses.
In the case of minor entropion without ligaments laxity the so called transverse everting sutures (rotation sutures) can be applied. They are absorbable and do not need to be removed. However, the effect of this procedure is generally not long-lasting.
In other cases, the following surgical procedures are used:
- Wies procedure, which involves a transverse full thickens incision made in the eyelid and lid eversion with everting sutures.
- the Four-snip Operation (modification of Quickert operation), which combines eversion and shortening of the eyelid, and also corrects horizontal lid laxity; it is the most time consuming method, but its effect is long-lasting.
After the surgery a dressing and an antibiotic ointment are applied. Skin sutures are removed after 7-10 days, and absorbable ones are left until they self absorb.
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