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 power ...

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 (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 na ...

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 disease, illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormali ...

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 to

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 tera ...

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 hou ...

* 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 un ...

, 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 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 pat ...

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 wolf. Also called the domestic dog, it is derived from the extinct Pleistocene wolf, and the modern wolf is the dog's nearest living relative. Do ...

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 the p ...

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

Akita is a Japanese name and may refer to: Places * 8182 Akita, a main-belt asteroid * Akita Castle, a Nara period fortified settlement in Akita, Japan * Akita Domain, also known as Kubota Domain, feudal domain in Edo period Japan * Akita, Kumamoto ...

Pug The Pug is a breed of dog originally from China, with physically distinctive features of a wrinkly, short-muzzled face and curled tail. The breed has a fine, glossy coat that comes in a variety of colors, most often light brown (Fawn (colour) ...

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 Mandarin: 沙皮 ''shā pí'') 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 ...

, 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, Cocker ...

Boxer Boxer most commonly refers to: * Boxer (boxing), a competitor in the sport of boxing *Boxer (dog), a breed of dog Boxer or boxers may also refer to: Animal kingdom * Boxer crab * Boxer shrimp, a small group of decapod crustaceans * Boxer snipe ee ...

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 Wels ...

Welsh Springer Spaniel The Welsh Springer Spaniel (''Welsh'': ''Llamgi 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 and historically have ...

, Labrador Retriever,

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Neapolitan Mastiff The Neapolitan Mastiff or is an Italian breed of large dog of mastiff type. It descends from the traditional guard dogs of central Italy. It was recognised as a breed by the Ente Nazionale della Cinofilia Italiana in 1949, and accepted by the ...

Bull Mastiff The Bullmastiff is a British breed of dog of mastiff type and large size, with a solid build and a short muzzle. It was developed as a guard dog in the nineteenth century by cross-breeding the English Mastiff with the now-extinct Old English ...

Great Dane The Great Dane is a large sized dog breed originating from Germany. The Great Dane descends from hunting dogs from the Middle Ages used to hunt wild boar and deer, and as guardians of German nobility. It is one of the largest breeds in the world ...

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 The is a breed of hunting dog from Japan. A small-to-medium breed, it is the smallest of the six original and distinct spitz breeds of dog native to Japan. Its name literally translates to "firewood dog". A small, alert, and agile dog that c ...

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 mea ...

Poodle , nickname = , stock = , country = Germany or France (see history) , height = , maleheight = , femaleheight = , weight = , maleweight = , femaleweight = , coat ...

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, ''l ...

. 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 Enophthalmos is a posterior displacement of the eyeball within the orbit. It is due to either enlargement of the bony orbit and/or reduction of the orbital content, this in relation to each other. It should not be confused with its opposite, ex ...

. 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 typical for its species. It is perceived as a desirable trait in some domesticated dog and cat breeds, ...

breeds (mostly the

Persian Persian may refer to: * People and things from Iran, historically called ''Persia'' in the English language ** Persians, the majority ethnic group in Iran, not to be conflated with the Iranic peoples ** Persian language, an Iranian language of the ...

) and the

Maine Coon The Maine Coon is a large domesticated cat breed. It is one of the oldest natural breeds in North America. The breed originated in the U.S. state of Maine, where it is the official state cat. The breed was popular in cat shows in the late 19t ...

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 pat ...

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 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 borders of a short ...

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