Entropion

Entropion

Entropion is the term used for an eyelid that rolls inwards. This usually causes discomfort and sticky discharge due to the lashes rubbing on the surface of the eye. It may also damage the ocular surface in the long term. The most common cause of entropion is age related change to the skin and muscles that dictate the normal position and tension of the lower lid.

If an entropion is present lubricant drops and ointment should be used to protect the surface of the eye, and medical tape can be used to stop the eyelid rolling in as temporary measure. Botox injections can also be used for temporary relief. The definitive approach to correcting an entropion is via surgical repair.

Entropion surgery is generally safe and is performed as a day case procedure. It has a high success rate and patient satisfaction.

Miles is a triple fellowship trained oculoplastic surgeon with specific expertise in eyelid plastic surgery. He regularly performs lower eyelid malposition (entropion and ectropion) surgery.

Entropion surgery

  • Procedure time 1hr

  • Anaesthetic Local or General

  • Downtime 7 days

  • Driving 5 days

  • Exercise 7 days

  • Final result 2-3 months

  • Entropion surgery usually involves tightening the lower eyelid and repairing the muscle that pulls the eyelid down. There is usually a small skin incision at the outer corner of the eye which is hidden in a skin crease and almost undetectable. There may also be a second incision just under the lashes which fades in a way that is usually undetectable.

    Sutures are removed at 5-10days following surgery.

    There is a >95% success rate with this surgery and high rates of satisfaction.

  • The recovery period is typically two weeks. The final result of surgery is appreciated at around two to three months.

    Discomfort is minimal following the surgery, controlled with simple pain killers such as paracetamol.

    Antibiotic ointment is prescribed to apply to the skin incisions twice a day for two weeks post-operatively.

    Sutures are removed at 5-10 days following surgery. Scarring is minimal and usually undetectable.

    Swelling and bruising varies between patients but can take up to 4 weeks to resolve. Cold compresses and sleeping propped up in the days following surgery can speed up recovery.

  • Entropion surgery is generally considered to be safe.

    As with any oculoplastic procedure, there are potential risks including infection, bleeding, scarring, asymmetry, over- or under-correction, and need for further surgery. Thankfully these complications are unusual.

    Infection

    Post-operative infection is very rare and can be treated with antibiotics. Further surgery may be required and cosmesis can be affected. A severe infection is extremely unlikely.

    Bleeding

    A small amount of bloody discharge from the skin incision is expected post-operatively.

    Scarring

    Surgical incisions are meticulously planned to minimise scarring. Scarring following entropion surgery is typically very subtle.

    Asymmetry

    When comparing the two sides of the face, we are all slightly asymmetrical. During the healing phase following surgery, especially if you have have surgery on one side, asymmetry may be noted and the eyelid(s) may feel tight. This is by design and they will relax to the correct position in the weeks following surgery. The vast majority of patients are very happy with final results.

    Allergy

    Allergic reactions are rare and precautions are taken for anyone with pre-existing allergies.

    Short and Long Term Outcomes

    Final results are seen at 2-3 months and should last for many years. It is unusual to need to repeat this procedure again in the future.

Miles is a consultant ophthalmologist and oculoplastic surgeon with a private practice at The London Clinic on Harley Street. He specialises in ophthalmic cosmetic, reconstructive, and lacrimal (tear drainage) surgery.

In addition to his private practice, Miles holds a substantive NHS consultant post at the Royal Free London and he established and runs the oculoplastic service at North Middlesex University Hospital. He also has expertise in cataract and pterygium surgery.

As an honorary clinical lecturer at UCL and assistant professor at St. George's University, Miles is actively involved in training the next generation of ophthalmologists.