Artificial tears and lubricating ointments can relieve the symptoms of entropion but surgery is usually required to fully correct this condition.

How does entropion surgery work?

Entropion surgery is one of the most common surgeries performed by oculoplastic surgeons. It is important to choose a highly skilled oculoplastic surgeon with significant experience in performing this type of surgery.

The approach to correcting the lower and upper lid is different:

Lower Lid Correction – here we need to address both the weakness of the lower lid muscle and the horizontal laxity of the eyelid, tightening and correcting the lower lids. Tightening of the eyelid is akin to tightening the guy ropes on a tent, for stability. With ageing the lower lids can develop loose skin, this can be corrected at the same time as correcting the lid position.

Upper Lid Correction – upper lid entropion is often caused by scarring under the upper lid, pulling down the lashes so they touch the cornea. Correction of this involves sliding the front (lamellar) of the lid (skin and lashes) back over the inner layer (lamellar) of the lid. This rotates the upper lashes away from the cornea.

Entropion surgery explained

Generally, entropion surgery for adults must be performed under local anaesthetic whilst the patient is awake to ensure maximum accuracy. A small amount of sedation can be used for those who are anxious of surgery, your consultant will discuss this with you during your initial consultation. Using washable ink pens, an incision line is marked under the lashes and out into the laughter line. The lower lid is injected with local anaesthetic to numb it. You will be moved to the operating theatre where your face will be prepped and draped for surgery. Your surgeon will then begin surgery. The inferior retractor muscle is carefully identified and securely reattached to the eyelid. To secure the lid position, the lower lid is tightened. Any excess lower lid skin is carefully removed. Finally, the skin is closed with very fine stitches. The procedure will be performed on both eyes on the same day.

Post-surgery guidelines

It is common for the eyelid area to be bruised, swollen and sore following surgery. It typically takes 1-2 weeks for the discomfort to subside. Scars are kept to a minimum by making incisions on the patient’s natural crease.

The eye will be covered with an eye pad. If both eyes were treated one eye pad will be removed after an hour, the other will remain in place until the following morning. You must ensure you wash your hands thoroughly before removing your eye pads.

Patients are usually advised to take a week off work to recover and to pre-arrange transport home following surgery. Driving yourself home is strongly discouraged on the day of surgery.

As with any surgical procedure, there is a small risk of infection and bleeding post-surgery – this is however very rare. Washing your hands prior to handing the area around your eyes is advised to reduce the risk of infection. We advise you do not wear make-up for at least one week after your procedure. Post-operative antibiotic ointment is supplied to apply to the wound for two weeks. A follow-up appointment is made for approximately two weeks after surgery.

Is entropion surgery the right procedure for me?

Although there will be some short-term discomfort following surgery, successful entropion surgery will typically fix your turning-in eyelids immediately. It is important to correct an in-turning lid as the lashes can damage the cornea, occasionally even causing a corneal ulcer. An entropion can be very uncomfortable.  

Prior to surgery, a full consultation will be carried out by your chosen consultant which includes an analysis of your eyelid function, position, laxity, as well as overall facial structure. We recognise that each patient is unique, your treatment plan will be tailored to you.

Who will I see for treatment?

Mr Meredith is a Consultant Eye Surgeon with a special interest in Oculoplastic (eyelid), Lacrimal (watery eye), Orbital and Cataract Surgery with clinics available on a Monday afternoon.

Mr Boyce is a Consultant Eye Surgeon with a special interest in Oculoplastic (eyelid) surgery and Dry Eye treatment with clinics available on a Wednesday afternoon.