Entropion (Inward Turning Eyelid) — Newcastle Eyelid Specialist
Entropion is one of the most common eyelid conditions I treat in my clinic in Newcastle. Patients typically come to me complaining of a persistently sore, watering, or gritty eye, often having tried lubricating eye drops for some time before realising the problem is actually caused by the position of the eyelid itself.
Once the eyelid is correctly repositioned, most patients experience a significant and rapid improvement in their symptoms.
What is entropion?
Entropion is a condition in which the lower eyelid turns inwards towards the eye. When this happens, the eyelashes and the skin of the eyelid rub continuously against the surface of the eye, the cornea, causing irritation, watering and discomfort.
It most commonly affects the lower eyelid and tends to develop gradually as part of the natural ageing process.
What causes entropion?
The most common cause is age-related weakening and loosening of the tissues that support the lower eyelid. As the tendons and muscles that hold the eyelid in its normal position become lax over time, the eyelid can begin to rotate inwards.
Less commonly, entropion can be caused by:
Scarring of the inner surface of the eyelid, sometimes following previous surgery, infection, or inflammatory conditions such as chronic blepharitis
Spasm of the eyelid muscles, which can cause the eyelid to turn in intermittently, this is sometimes triggered by eye irritation or inflammation
Previous trauma to the eyelid
In the majority of patients I see, the cause is straightforward age-related laxity, and the diagnosis is confirmed during a clinical examination.
What are the symptoms of entropion?
A persistently sore, red, or irritated eye
A gritty or scratchy sensation, as though something is in the eye
Watering of the eye
Sensitivity to light
Blurred vision
Redness of the white of the eye
Many patients find that their symptoms are worse first thing in the morning or in windy conditions. Some people notice that the eyelid only turns in at certain times — for example when blinking forcefully or closing the eye tightly, which can make the condition intermittently more troublesome.
If left untreated, the repeated rubbing of the lashes against the cornea can cause corneal abrasions and, in some cases, scarring that may affect vision. For this reason, it is worth seeking an assessment sooner rather than later.
When should you see a specialist?
You should arrange an assessment if you have:
A persistently sore, watering, or red eye that has not improved with lubricating drops
A visible inward rolling of the lower eyelid
Increasing discomfort or sensitivity to light
Any sudden worsening of symptoms, pain, or a significant deterioration in vision — in which case you should seek prompt advice
In some cases, a GP or optometrist may notice the eyelid turning in during a routine examination and refer you on. Either way, a specialist assessment will help confirm the diagnosis and identify the most appropriate treatment.
What happens at a consultation?
During your appointment I will examine both eyelids and assess the degree to which the lower eyelid has turned in. I will also look at the surface of the eye to check whether the cornea has been affected by the rubbing of the lashes.
I will ask about how long you have had symptoms, whether they are constant or intermittent, and what impact they are having on your day-to-day life. This helps me to determine the most appropriate surgical approach.
If surgery is recommended, I will explain the procedure in full and give you the opportunity to ask any questions before making a decision.
How is entropion treated?
Entropion is treated surgically. Eye drops and lubricants can offer some temporary relief from the symptoms but they do not correct the position of the eyelid. Surgery is the only reliable long-term solution.
The procedure involves tightening and repositioning the lower eyelid so that it sits correctly against the eye and the lashes no longer make contact with the cornea.
The procedure:
Is performed under local anaesthetic as a day case — you will be awake but the eyelid area will be fully numbed
Usually takes around 20 to 30 minutes
Is performed through a small incision at the outer corner of the eyelid, which heals very well
Uses fine absorbable stitches that do not need to be removed
Is entropion surgery painful?
The procedure itself is not painful. Local anaesthetic is injected at the start, which causes a brief stinging sensation before the area becomes numb. Most patients tell me they are surprised by how straightforward and comfortable the procedure is.
Some mild discomfort and a feeling of tightness around the eyelid is normal in the days after surgery, and is usually well managed with paracetamol.
What is the recovery like after entropion surgery?
Some swelling, bruising, and crusting around the eyelid is expected in the first few days after surgery. This gradually settles over one to two weeks.
Most patients notice a significant improvement in their symptoms very quickly, often within days of surgery, once the eyelid is sitting in its correct position and the lashes are no longer rubbing against the eye.
Most people are comfortable returning to light activities and desk-based work within a few days. I advise avoiding strenuous exercise and swimming for around two weeks.
A follow-up appointment can be arranged to check on healing and ensure you are satisfied with the outcome.
What results can I expect?
The aim of surgery is to restore the lower eyelid to its normal position, relieving the irritation, watering, and discomfort caused by the inturning lashes. Most patients experience a very noticeable improvement in comfort and a reduction in watering shortly after the procedure.
As with any surgical procedure, there is a small chance that the eyelid may turn in again over time, particularly as the tissues continue to age. This is uncommon but would be discussed with you at your consultation.
Entropion surgery at Newmedica Eye Clinic, Newcastle
All procedures are performed at the Newmedica Eye Clinic in Newcastle upon Tyne, a modern, purpose-built outpatient surgical facility. Treatment is available on a private, self-pay basis.
If you are troubled by a sore or watering eye and think your eyelid may be turning in, I would be happy to see you in clinic, assess the eyelid, and talk through the treatment options.