Entropion is a

medical condition A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medica ...

in which the

eyelid An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eyel ...

(usually the lower lid) folds inward. It is very uncomfortable, as the

eyelash An eyelash (also called lash) (Latin: ''Cilia'') is one of the hairs that grows at the edge of the eyelids. It grows in one layer on the edge of the upper and lower eyelids. Eyelashes protect the eye from debris, dust, and small particles and p ...

es continuously rub against the

cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical ...

causing irritation. Entropion is usually caused by genetic factors. This is different from when an extra fold of skin on the lower eyelid causes lashes to turn in towards the eye (

epiblepharon Epiblepharon is a condition characterised by a congenital horizontal fold of skin near the margin of the upper or lower eyelid caused by the abnormal insertion of muscle fibres.This extra fold of skin redirects the lashes into a vertical position, ...

). In epiblepharons, the eyelid margin itself is in the correct position, but the extra fold of skin causes the lashes to be misdirected. Entropion can also create secondary pain of the

eye Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and conv ...

(leading to self trauma, scarring of the eyelid, or nerve damage). The upper or lower eyelid can be involved, and one or both eyes may be affected. When entropion occurs in both eyes, this is known as "bilateral entropion". Repeated cases of

trachoma Trachoma is an infectious disease caused by bacterium '' Chlamydia trachomatis''. The infection causes a roughening of the inner surface of the eyelids. This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea of ...

infection may cause

scar A scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a n ...

ring of the inner eyelid, which may cause entropion. In human cases, this condition is most common to people over 60 years of age.

Symptoms

Symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showi ...

of entropion include: * Redness and

pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...

around the eye *

Sensitivity Sensitivity may refer to: Science and technology Natural sciences * Sensitivity (physiology), the ability of an organism or organ to respond to external stimuli ** Sensory processing sensitivity in humans * Sensitivity and specificity, statisti ...

light Light or visible light is electromagnetic radiation that can be perceived by the human eye. Visible light is usually defined as having wavelengths in the range of 400–700 nanometres (nm), corresponding to frequencies of 750–420 te ...

and

wind Wind is the natural movement of air or other gases relative to a planet's surface. Winds occur on a range of scales, from thunderstorm flows lasting tens of minutes, to local breezes generated by heating of land surfaces and lasting a few ...

* Sagging

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...

around the eye * Eye watering * Decreased

vision Vision, Visions, or The Vision may refer to: Perception Optical perception * Visual perception, the sense of sight * Visual system, the physical mechanism of eyesight * Computer vision, a field dealing with how computers can be made to gain und ...

, especially if the

is damaged

Causes

*Congenital *Aging creating loose skin and stretched and loose ligaments and muscles (senile entropion). *Scarring (mechanical entropion) *Spasm *An eye infection called trachoma is still common in North Africa and South Asia and this can cause scarring of the inner eyelid, which may cause friction and entropion.

Treatment

Treatment is a relatively simple surgery in which excess skin of the outer lids is removed or tendons and muscles are shortened with one or two stitches. General anesthesia is sometimes used before local anesthetics are injected into the muscles around the eye. Prognosis is excellent if surgery is performed before the cornea is damaged.

Entropion in other species

Entropion has been documented in most dog breeds, although there are some breeds (particularly

purebred Purebreds are " cultivated varieties" of an animal species achieved through the process of selective breeding. When the lineage of a purebred animal is recorded, that animal is said to be " pedigreed". Purebreds breed true-to-type which means th ...

s) that are more commonly affected than others. These include the Akita, Pug,

Chow Chow The Chow Chow is a spitz-type of dog breed originally from northern China. The Chow Chow is a sturdily built dog, square in profile, with a broad skull and small, triangular, erect ears with rounded tips. The breed is known for a very dense ...

Shar Pei The Shar Pei (Cantonese: ''shā pèih'' or Standard Chinese, Mandarin: 沙皮 ''shā pí'') is a dog breed from South China, southern China. Traditionally kept as a property guardian, the Shar Pei was driven to the brink of extinction in the 20th ...

, St. Bernard,

Cocker Spaniel Cocker Spaniels are dogs belonging to two breeds of the spaniel dog type: the American Cocker Spaniel and the English Cocker Spaniel of which are commonly called simply Cocker Spaniel in their countries of origin. In the early 20th century, Cock ...

, Boxer,

English Springer Spaniel The English Springer is a breed of gun dog in the Spaniel group traditionally used for flushing and retrieving game. It is an affectionate, excitable breed with a typical lifespan of twelve to fourteen years. They are very similar to the W ...

, Welsh Springer Spaniel, Labrador Retriever,

Cavalier King Charles Spaniel The Cavalier King Charles Spaniel is a British breed of toy dog of spaniel type. Four colours are recognised: Blenheim (chestnut and white), tricolour (black/white/tan), black and tan, and ruby; the coat is smooth and silky. The lifespan is u ...

, Neapolitan Mastiff, Bull Mastiff, Great Dane,

Irish Setter The Irish Setter ( ga, sotar rua, literally "red setter") is a setter, a breed of gundog, and family dog. The term ''Irish Setter'' is commonly used to encompass the show-bred dog recognised by the American Kennel Club as well as the field-bred ...

, Shiba Inu,

Rottweiler The Rottweiler (, ) is a breed of domestic dog, regarded as medium-to-large or large. The dogs were known in German as , meaning Rottweil butchers' dogs, because their main use was to herd livestock and pull carts laden with butchered m ...

Poodle The Poodle, called the Pudel in German and the Caniche in French, is a breed of water dog. The breed is divided into four varieties based on size, the Standard Poodle, Medium Poodle, Miniature Poodle and Toy Poodle, although the Medium Poodle va ...

and particularly

Bloodhound The bloodhound is a large scent hound, originally bred for hunting deer, wild boar and, since the Middle Ages, for tracking people. Believed to be descended from hounds once kept at the Abbey of Saint-Hubert, Belgium, in French it is called ...

. The condition is usually present by six months of age. If left untreated, the condition can cause such trauma to the eye that it will require removal. Feline Entropion OS

Entropion has also been seen in

cat The cat (''Felis catus'') is a domestic species of small carnivorous mammal. It is the only domesticated species in the family Felidae and is commonly referred to as the domestic cat or house cat to distinguish it from the wild members of ...

breeds. Typically it is secondary to trauma or infection leading to chronic eyelid changes. It is also seen secondary to enophthalmos. Primary entropion might also be encountered : the brachycephalic breeds (mostly the Persian) and the Maine Coon are predisposed. Upper-lid entropion involves the

es rubbing on the eye, but the lower lid usually has no eyelashes, so little or no hair rubs on the eye.

Surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...

correction is used in more severe cases. A number of techniques for surgical correction exist. The Hotz-Celsus technique involves the removal of strip of skin and orbicularis oculi muscle parallel to the affected portion of the lid and then the skin is sutured. Alternative techniques such as the Wyman technique focus on tightening the lower eyelid. This technique is not as effective in cases of enophthalmos.

s, who often are affected as young as two or three weeks old, respond well to temporary eyelid tacking. The entropion is often corrected after three to four weeks, and the sutures are removed.

References

External links