Entropion is a

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

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. "Palpebral ...

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

eyelash An eyelash (also called lash) (Neo-Latin: ''cilium'', plural ''cilia'') is one of the hairs that grows at the edges of the top and bottom eyelids, spanning outwards and away from the eyes. The lashes grow in up to six layers on each of the upper ...

es continuously rub against the

cornea The cornea is the transparency (optics), transparent front part of the eyeball which covers the Iris (anatomy), iris, pupil, and Anterior chamber of eyeball, anterior chamber. Along with the anterior chamber and Lens (anatomy), lens, the cornea ...

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). 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 An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...

(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 ...

infection may cause

scar A scar (or scar tissue) is an area of fibrosis, 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 Organ (anatomy), organs, and biological tissue, t ...

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 diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

of entropion include: * Redness and

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

around the eye * Sensitivity to

light Light, visible light, or visible radiation is electromagnetic radiation that can be visual perception, perceived by the human eye. Visible light spans the visible spectrum and is usually defined as having wavelengths in the range of 400– ...

and

wind Wind is the natural movement of atmosphere of Earth, air or other gases relative to a planetary surface, planet's surface. Winds occur on a range of scales, from thunderstorm flows lasting tens of minutes, to local breezes generated by heatin ...

* 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 animal coverings, such as the arthropod exoskeleton, have different ...

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

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 Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

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 The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the gray wolf. Also called the domestic dog, it was selectively bred from a population of wolves during the Late Pleistocene by hunter-gatherers. ...

breeds, although there are some breeds (particularly

purebred Purebreds are cultivars 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 the progeny of l ...

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

Pug The Pug is a breed of dog with the physically distinctive features of a wrinkly, short-muzzled face, and curled tail. An ancient breed, with roots dating back to 400 B.C., they have a fine, glossy coat that comes in a variety of colors, most ...

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 do ...

Shar Pei The Shar Pei () is a dog breed from southern China. Traditionally kept as a property guardian, the shar pei was driven to the brink of extinction in the 20th century. The breed is known in the West for its deep wrinkles, while a traditional less ...

, St. Bernard, Cocker Spaniel, Boxer,

English Springer Spaniel The English Springer Spaniel is a breed of gun dog in the Spaniel group traditionally used for flushing and retrieving game. They are descended from the Norfolk or Shropshire Spaniels of the mid-19th century; the breed has diverged into sepa ...

Welsh Springer Spaniel The Welsh Springer Spaniel (''Welsh'': ''Llamgi Cymru'' or ''Tarfgi Cymru'') is a dog breed, breed of dog and a member of the spaniel family. Thought to be comparable to the old Land Spaniel, they are similar to the English Springer Spaniel a ...

Labrador Retriever The Labrador Retriever or simply Labrador or Lab is a British list of dog breeds, breed of water dog retriever gun dog. It was developed in the United Kingdom from St. John's water dogs imported from the Newfoundland Colony, colony of Newfoun ...

Cavalier King Charles Spaniel The Cavalier King Charles Spaniel (CKCS) is a British list of dog breeds, breed of toy dog of spaniel type. Four colours are recognised: Blenheim (chestnut and white), Tricolor (dog), tricolour (black/white/tan), black and tan, and ruby; the coa ...

Neapolitan Mastiff The Neapolitan Mastiff or is an Italian breed of large dog of mastiff type. It was recognised as a breed by the Ente Nazionale della Cinofilia Italiana in 1949, and accepted by the Fédération Cynologique Internationale in 1956. It descends ...

, Bull Mastiff,

Great Dane The Great Dane is a German list of dog breeds, breed of large mastiff-sighthound, which descends from hunting dogs of the Middle Ages used to hunt bears, wild boar, and deer. They were also used as guardian dogs of German nobility. It is one o ...

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

Shiba Inu The is a breed of hunting dog from Japan. A small-to-medium breed, it is the smallest of the six original dog breeds native to Japan. The Shiba Inu was originally bred for hunting. Its name literally translates to "brushwood dog", as it is us ...

, Rottweiler,

Poodle The Poodle, called the in German () and the 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 is no ...

and particularly

Bloodhound The bloodhound is a large scent hound, originally bred for hunting deer, wild boar, rabbits, 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 ...

. 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''), also referred to as the domestic cat or house cat, is a small domesticated carnivorous mammal. It is the only domesticated species of the family Felidae. Advances in archaeology and genetics have shown that the ...

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 Brachycephaly (derived from the Ancient Greek '' βραχύς'', 'short' and '' κεφαλή'', 'head') is the shape of a skull shorter than average in its species. It is perceived as a cosmetically desirable trait in some domesticated dog and ...

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 is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

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 The orbicularis oculi is a sphincter-like muscle in the face that closes the eyelids. It arises from the nasal part of the frontal bone, from the frontal process of the maxilla in front of the lacrimal groove, and from the anterior surface and b ...

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