When Your Eyelashes Turn in and Rub your Eye

My mother has been bothered for quite some time by her eyelids, which have turned in on themselves and now the edges of her lower lid and lashes rub against her eye. I had no idea this was even a condition until I googled it and came up with not only a specific diagnosis but also a name: Entropion.

Symptoms of Entropion

As you can imagine, this is an extremely irritating condition which causes inflammation of the cornea and conjunctiva (the transparent layer which covers the white of your eye and lines your eyelids, much like the membrane lining an eggshell). Apart from irritated eyes (it usually feels like sand or grit is in your eye) you can actually see your eyelids turning in. You may also experience a discharge or pus coming from your eye.

There are four different types of Entropion

1. Congenital Entropion: Some people are born with this disease of the eye, though it's extremely rare. It usually begins to manifest in children with some sort of facial paralysis and generally only affects the lower lids.
   
2. Acute Spastic Entropion: Is common after eye surgery, trauma, or eye infections, but can occur without them as well. It's caused by the spastic tightening of the muscles surrounding the eye. A lot of these patients also have a component of involutional entropion as well.
3. Involutional Entropion: This manifestation of entropion is also sometimes referred to as senile entropion (and it's the one my mother is most likely to have. Needless to say, she was not thrilled with the name) because it mostly occurs in older people and only affects the lower lids. It's, unfortunately, due to the changes that occur to the muscles and tendons surrounding the eye when you age.
4. Cicatrical Entropion: This form of entropion is caused by scratches on the surface of the conjunctiva. These can come from chemical burns, improper healing of scar tissue, Stevens-Johnson syndrome, chronic infections or even a bad reaction to topical medicines.
   

Your doctor will first need to determine that you do indeed have entropion and not another form of eye disease. There are several that can be mistaken for entropion because of similar symptoms however, treatment is different. These are:

• Trichiasis: is actually a fairly common malady of the eye with very similar symptoms to entropion.
• Epiblepharon: This is a congenital disease of the eye affecting the muscles and skin.
  
• Eyelid Retraction: A tightening of the eye muscles.
  

Sometimes the disease will actually spontaneously correct itself, however, more often, some sort of intervention is needed. This will depend on the type of entropion that you have but options include:

• The most successful form of therapy is surgery, however...
  
• Eye Drops to help lubricate the eye can help to protect the ocular surface and may also break the cycle in patients with spastic entropion due to dry eye syndrome.
• Antibiotics and Corticosteroids can be useful in treating autoimmune diseases that affect the eye such as Blepharitis, which may cause spastic entropion.
• Botox is also especially useful in treating spastic entropion.
• Some patients with cicatricial entropion are treated with chemo therapy.
  

Sometimes you can use surgical tape to pull the eyelids away from the eye (your doctor may even try this) but, for obvious reasons, this is only for temporary relief of symptoms.

Dogs and cats can be affected by entropion as well. In fact, it's actually fairly common in certain breeds of dogs such as the Bloodhound, Bulldog, Retrievers, Chow Chow, Rottweiler, and Shar Pei. With cats, less so though certain short faced breeds of cats such as Burmese, Persian and Maine Coon can be affected. Normally, cats who do acquire feline entropion do so later in life as a result of an injury or, more commonly, a manifestation of the herpes virus.

The symptoms are very similar to those in humans.

Surgery is the corrective treatment of choice for dogs and cats, just as with humans. Though, you should wait until your puppy is at least six months old to ensure that the eyes have developed enough. If you don't have your pet's entropion corrected, it can eventually cause corneal ulceration, pigmentation, and scarring which may cause blindness.

The American Kennel Association doesn't allowing showing of dogs with "cosmetic surgery," and they classify entropion surgery as cosmetic, though if your dog has been diagnosed with spastic entropion then you will be able to breed it.

If you suspect that you, or someone you know has this disease, the best course of action is swift diagnosis and treatment by an eye specialist.

Article by Anne Alexander Sieder, all rights reserved.