Entropion Lower Eyelid
Entropion is a turning in of the lower eyelid. This causes the eyelashes to rub up against the eye. The person with this problem complains of redness, pain and irritation of the eye. This can lead to infection, corneal abrasion, and possible corneal ulceration.
There are two opposing sets of eyelid muscles that oppose each other. One muscle system (eyelids retractors) pulls the eyelid away from the eye. The other muscle system (orbicularis oculi) pulls the eyelid towards the eye. If there is an imbalance in these two muscle system then the eyelid can turn in or out. When the muscles pulling the eyelid towards the eye are stronger than the ones turning the eyelid out, entropion of the lower eyelid is the result.
Causes of Entropion
Age and the Eyelid
Imbalances in muscle tone are more common with age. The eyelid is like a hammock with the eyelid attached on each end to the bone around the eye with the medial and lateral canthal tendons. These tissues stretch with age, making it easier for the eyelid to turn in just like a hammock flipping over.
Cicatricial or Scarring of the Eyelid
Scarring or defects in the tarsal plate in the eyelid can result in entropion. The tarsal plate of cartilage provides support to the eyelid. There can also be scarring of the conjunctiva from chemical burns, trauma, Stevens – Johnson syndrome, ocular pemphigoid, or infections.
Congenital entropion of the lower eyelid is rare. It can be due to lack of proper tissue in the eyelid or dysgenesis of the lower eyelid retractors.
There is a turning in of the lower eyelid to the point of a spasm of the lower eyelid orbicularis muscle.
Treatment of Entropion
Surgical correction of the underlying problem is usually necessary to resolve the problem. Surgery is aimed at strengthen the muscles that draw the eyelid away from the eye. Sometimes tightening the lower eyelid will be all that is required. Surgery is done with local anesthesia and takes only a few minutes.