Causes of Entropion and Correction Methods

When the edge of the eyelid rolls inward,

the eyelashes repeatedly come into contact with the surface of the eye.

At first, this may feel like mild foreign-body sensation,

but if the condition persists without appropriate treatment,

it begins to affect eye health.

This condition

is called entropion.

In its early stages, it may feel like nothing more than eye fatigue,

which makes it easy to overlook.

Although it does not occur only in a specific age group,

statistics from the Health Insurance Review and Assessment Service show

that the number of visits among middle-aged and older adults in their 50s and above

has been steadily increasing.

Entropion is a condition in which the eyelashes and eyelid skin

rub against the cornea and conjunctiva.

Normally, an appropriate gap is maintained between the eyelid and the eyeball,

and the eyelashes point outward,

but when this structure becomes deformed, the eyelashes touch the eyeball

and continuously irritate the surface of the eye.

It generally occurs when the muscles or ligaments that support the structure

become deformed.

Because the eyeball is touched every time a person blinks,

even when there are no clear subjective symptoms,

the irritation and strain gradually increase.

The causes of entropion can be divided into two categories.

When it occurs because the muscles did not develop evenly from birth,

it is classified as congenital and

is more commonly found in the lower eyelid.

Acquired entropion is divided into three types:

age-related tissue laxity, conjunctival scarring,

and inflammation around the eyes.

Among these, involutional entropion

is more common in middle-aged and older adults over 50

and is increasing along with the aging population.

When inflammation continues for a long time due to atopic dermatitis

or chronic conjunctivitis,

firm scar tissue may form in the mucous membrane,

resulting in cicatricial entropion.

The most common symptom is

a sensation that something is in the eye.

A rough, scratchy irritation may be felt with every blink.

When the corneal surface is repeatedly irritated,

the eyes may water for no apparent reason,

and light sensitivity or redness may also occur.

If eye discharge occurs more often than usual

and redness around the eyes continues,

it may not be simple fatigue.

As the condition progresses, eyelid spasms may develop,

or it may lead to blurred vision,

so it is not a condition that should be taken lightly.

If it is left untreated,

repeated abrasions caused by the eyelashes

can accumulate damage on the surface of the eye.

Areas subject to frequent friction become vulnerable to bacteria,

increasing the risk of secondary infections such as conjunctivitis.

If the condition worsens, the cornea may become cloudy

and the problem may progress to keratitis or an ulcer.

This process can also occur in infants and young children,

who often show their discomfort by blinking frequently

or rubbing their eyes.

Because they may have difficulty describing their symptoms themselves,

caregivers need to carefully observe even minor changes

such as redness or tearing.

If the condition is left untreated for a long time, vision may also decline,

so an early examination is advisable.

Artificial tears or medical tape

can only ease immediate discomfort

and cannot change the structural deformity itself.

If this situation continues to recur,

temporary measures alone have limitations.

In such cases,

correction surgery for entropion

is needed to improve the affected area.

Its purpose is to move the eyelid

back toward its normal position

so that the eyelashes do not touch the eyeball.

Because the appropriate method varies according to the type and severity of entropion,

careful diagnosis is needed for each individual.

The procedure is usually performed under local anesthesia,

so even older adults for whom general anesthesia may be burdensome

can undergo it without undue difficulty.

Correction methods are broadly

divided into suturing and incision methods.

The suturing method does not involve cutting the skin.

Instead, absorbable sutures are used to tie the inner tissues of the eyelid,

turning the inverted direction outward.

The sutures are passed through the inside of the eyelid

to hold back the movement of the tissues

that tend to roll inward.

It places less physical strain and raises less concern about scarring,

and the procedure is brief, allowing for quick recovery.

However, recurrence is possible over time,

so it is mainly used for mild symptoms

or as a temporary option for infants and young children.

In contrast, the incision method directly opens the tissue

and repositions the internal structures,

addressing the underlying cause of entropion.

Loose or damaged areas are removed,

and the retractor muscle is reattached

and firmly secured in the proper position.

In this way, loosely stretched tissue

is supported as it was originally.

It is selected when the deformity is severe

or the risk of recurrence is high,

as in cicatricial or involutional entropion.

Because it produces a more substantial change than the suturing method

in a stable manner,

it can provide a longer-lasting result.

When horizontal laxity is pronounced,

correction of the lateral canthal area may also be performed

to improve the overall structural balance.

For several days after correction,

swelling and bruising may be visible,

but they usually subside over time.

During this period, it is essential to prevent physical irritation

from reaching the area around the eyes.

Prescribed eye drops or anti-inflammatory ointment

can aid recovery when applied consistently

according to the specified frequency and instructions.

It usually takes about 2 to 4 weeks

for major swelling to subside and the tissue to soften,

so excessive physical exercise,

saunas, and alcohol should be avoided during this period.

Washing the face and applying eye makeup should also be resumed gradually

according to the progress of wound healing.

Entropion is a progressive condition

in which corneal damage caused by the eyelashes

accumulates layer by layer over time.

If foreign-body sensation or redness continues to recur,

it may be a structural problem rather than simple fatigue,

so it is better not to attribute it solely to aging.

The appropriate correction approach should be determined

by considering the individual type of entropion,

the degree of mucosal laxity,

and the condition of the eye as a whole.

To protect valuable vision

and improve quality of daily life,

it is important to visit a medical institution in the early stages of symptoms

and undergo a thorough evaluation.

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