Mr Sohail Ahmed
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Entropion

What is an Entropion?

Entropion is a condition where the lower eyelid turns inward towards the eye, causing the eyelashes to rub against the cornea. This abnormality can disrupt the normal function of the eyelid, leading to irritation and potential damage to the eye because the eyelashes and skin are in constant contact with the cornea. Common symptoms include excessive tearing, redness, and a sensation of something in the eye. Entropion is most commonly associated with aging due to muscle weakness and relaxation of eyelid tissues, but it can also result from facial palsy, scarring, or previous surgeries. Treatment is crucial to relieve discomfort and prevent damage to the cornea and infections, with surgical procedures often recommended to restore the eyelid’s normal position.

Symptoms

The symptoms of entropion primarily stem from the inward turning of the lower eyelid, causing the eyelashes to rub against the cornea, leading to a range of discomforts. Individuals with entropion often experience excessive tearing due to irritation of the eye, alongside a gritty or scratchy sensation as the eyelashes continually contact the corneal surface. This constant irritation can also cause persistent redness, pain, and increased sensitivity to light and wind. In more severe cases, the continued improper eyelid function can lead to vision issues, including corneal abrasions or ulcers from the damage to the eye’s surface. If these symptoms are left untreated, they can escalate into more serious complications, emphasizing the importance of seeking timely medical attention.

Redness

Irritation

Watering

Light Sensitivity

What causes Entropion?

Age-related

The most common cause, where the tissues of the eyelid lose elasticity and muscle tone due to natural aging processes, leading to an inward turning of the eyelid.

Spasm/Inflammation

Sometimes, muscle spasms in the eyelid or chronic inflammation can temporarily or permanently cause the eyelid to turn inward. Conditions like blepharitis or trachoma can contribute to such changes.

Scarring

Scarring of the inner eyelid, which can result from chemical burns, inflammatory diseases, infections, or trauma, can lead to entropion. Scar tissue can contract, pulling the eyelid inward.

Congenital

Some individuals are born with entropion, often due to developmental issues affecting the muscles or skin around the eyelids.

Entropion Treatment

Treatment for entropion is primarily surgical, aimed at correcting the inward turning of the eyelid to prevent the eyelashes from rubbing against the cornea and causing further irritation or damage. The specific type of surgery may vary depending on the underlying cause of the entropion. For age-related entropion, the procedure typically involves tightening the eyelid and its attachments to restore its normal position. If entropion is caused by scar tissue, surgical interventions may include releasing the scar and grafting skin or using other techniques to allow the eyelid to revert to its normal position. In cases where entropion is caused by muscle spasms, Botox injections may be used temporarily to relieve the condition until more permanent solutions can be implemented. Non-surgical treatments, such as taping the eyelid or using artificial tears, may help alleviate symptoms but do not correct the underlying problem, making surgery often necessary to fully resolve the issue and protect the eye from serious complications.
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What are the risks?

Entropion surgery is highly effective in correcting the inward turning of the eyelid, improving both eye function and comfort. However, like any surgical procedure, it carries some potential risks. Although complications are uncommon, being informed about them is important.
Any surgery can introduce the risk of infection at the site of the operation, which might require additional treatment and delay healing.
While surgical techniques aim to minimize visible scars, some degree of scarring is possible, which could affect the appearance or function of the eyelid.
There is a possibility that the eyelid may be corrected too much or not enough, requiring further surgical intervention to achieve optimal results.
Minor bleeding is common, but excessive bleeding can occur during or after surgery, leading to bruising or more significant complications.
Post-operative adjustments might result in the eyelid not aligning perfectly, potentially necessitating additional corrective procedures
Patients may experience increased dry eye symptoms following surgery, which can usually be managed with eye drops or other treatments.
Your surgeon will discuss these risks in greater detail during your consultation, helping you to make an informed decision about the procedure. Remember that entropion surgery is generally very successful, with most patients experiencing significant improvements in symptoms and quality of life.

4 Tips to Improving Success

Achieve better outcomes with expert surgeons, advanced procedures, and a commitment to quality care. Our focus on precision, efficiency, and timely surgeries ensures your vision restoration is in trusted hands.

The Surgeon

The success of entropion repair largely depends on the expertise of your eye surgeon. As a consultant eye surgeon with extensive experience in eyelid corrections, I provide a meticulous and secure surgical experience. You can be assured that your procedure will be conducted with precision, aiming for the best possible outcomes.

The Procedure

Entropion repair is typically very safe and is performed on an outpatient basis. This surgery involves correcting the inward turning of the eyelid, often through procedures that may include tightening the affected muscles or tendons under local anaesthesia. I will guide you through the entire process, clearly explaining each step to ensure your comfort and understanding.

Quality Surgery

Achieving optimal results in a single procedure is crucial. As a Consultant Ophthalmic Surgeon with specialized expertise in eyelid surgeries, I am committed to delivering top-notch care and ensuring the best possible functional and aesthetic outcomes for your eyes.

Prompt Treatment

For entropion, it is essential to address the condition promptly when symptoms such as irritation and vision obstruction affect your daily life. I ensure a swift progression from your initial consultation to the surgical correction, often scheduling your procedure within a brief time frame to effectively restore both the function and appearance of your eyelid.

Entropion FAQs

Entropion repair significantly improves both eye health and comfort. Key benefits include:
⦁ Protection and Lubrication: Correcting the inward turning of the eyelid allows it to properly cover the eye, helping to maintain lubrication and protect against dryness, irritation, and infection.
⦁ Reduced Discomfort: Patients often experience relief from the constant irritation caused by eyelashes rubbing against the cornea. After surgery, symptoms like pain and the sensation of foreign objects in the eye typically diminish.
⦁ Improved Eye Health: Repairing the eyelid position can prevent further damage to the cornea and reduce the risk of corneal ulcers or scratches.
⦁ Enhanced Vision: By stopping the irritation of the cornea, visual clarity can improve, and secondary vision issues can be mitigated.
⦁ Cosmetic Improvement: Entropion repair can enhance the overall appearance of the eyes by restoring the natural position of the eyelids.

While generally safe, entropion repair carries certain risks, including:
⦁ Infection: Potential for infection at the surgical site, typically manageable with antibiotics.
⦁ Scarring: Possible visible scarring, although techniques aim to minimize this risk.
⦁ Overcorrection or Undercorrection: May require additional interventions to achieve the desired eyelid position.
⦁ Bleeding: Minor bleeding is common; however, excessive bleeding may lead to complications.
⦁ Changes in Eyelid Position: Unintended alterations in eyelid angle or contour could affect appearance and function.
⦁ Dry Eye Symptoms: Increased symptoms of dry eye which may necessitate further treatment.

Preparation involves discontinuing certain medications, fasting for a specific period before surgery, and arranging transportation home post-surgery. Your surgeon will provide a detailed list of pre-operative instructions.
The surgery typically involves correcting the inward turning of the eyelid through techniques like tightening ligaments or repositioning muscles, usually under local anaesthesia.
The surgery itself is performed under anaesthesia, minimizing pain; however, some post-operative discomfort and swelling can occur.
Expect some initial swelling and bruising, with possible discomfort. It’s crucial to follow post-operative care instructions, including using any prescribed medications and avoiding activities that strain the eyes.
Recovery times vary, but many patients resume normal activities within a week. Complete healing and final results may take a few weeks, during which strenuous activities should be avoided.
Most patients return to work within a week, depending on the nature of their job and the recovery progress. Jobs involving physical labour or dusty environments might require a longer recovery period.
Post-operative care generally involves applying antibiotic ointments, avoiding eye rubbing, and using artificial tears if needed. Keeping your head elevated while resting can also help reduce swelling.
Contact your surgeon or healthcare provider immediately if you notice severe pain, significant changes in vision, signs of infection, or if the eyelid position seems altered or unstable.
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