Title: Entropion

{{Short description|Inward folding of the eyelid}}
{{Infobox medical condition (new)
| name            = Entropion
| image           = Entropion and trichiasis secondary to trachoma A44-652-11.jpg
| caption         = Entropion and [[trichiasis]] secondary to [[trachoma]]
}}
'''Entropion''' is a [[medical condition]] in which the [[eyelid]] (usually the lower lid) folds inward.&lt;ref&gt;{{Cite web |title=Entropion |url=https://elementsofmorphology.nih.gov/index.cgi?tid=34a546ebf02511b5 |access-date=2022-10-30 |website=Elements of Morphology |publisher=National Human Genome Research Institute}}&lt;/ref&gt; It is very uncomfortable, as the [[eyelash]]es continuously rub against the [[cornea]] causing irritation. Entropion is usually caused by [[Genetics|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]]).&lt;ref&gt;{{Cite book|url=https://books.google.com/books?id=GRVBDwAAQBAJ&amp;dq=epiblepharon&amp;pg=PA336|title=Pediatric Oculoplastic Surgery|last1=Katowitz|first1=James A.|last2=Katowitz|first2=William R.|date=2017-11-30|publisher=Springer|isbn=978-3-319-60814-3|pages=336|language=en}}&lt;/ref&gt; 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 [[human eye|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 &quot;bilateral entropion&quot;. Repeated cases of [[trachoma]] infection may cause [[scar]]ring of the inner eyelid, which may cause entropion.&lt;ref name=&quot;Rabiu&quot;&gt;{{cite journal |vauthors=Rabiu M, Alhassan MB, Ejere HO, Evans JR |title= Environmental sanitary interventions for preventing active trachoma |journal=Cochrane Database of Systematic Reviews |volume=2 |article-number= CD004003 |date=2012 |issue= 2 |pmid= 22336798|doi= 10.1002/14651858.CD004003.PUB4|pmc=4422499}}&lt;/ref&gt; In human cases, this condition is most common to people over 60 years of age.&lt;ref&gt;Tony Smith, ed. (1992). ''The British Medical Association Family Doctor Home Adviser''. Chart 80: &quot;Painful or irritated eye&quot;. {{ISBN|0-86318-864-8}} p. 184&lt;/ref&gt;

==Symptoms and signs==
[[Symptoms]] of entropion include:{{cn|date=November 2025}}
* Redness and [[pain]] around the eye
* [[Sensitivity (human)|Sensitivity]] to [[light]] and [[wind]]
* Sagging [[skin]] around the eye
* [[Tears|Eye watering]]
* Decreased [[visual perception|vision]], especially if the [[cornea]] is damaged

==Causes==
The following are the causes:{{cn|date=November 2025}}
* 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]] 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.{{cn|date=November 2025}}

==Entropion in other species==
[[File:Canine entropion.JPG|thumb|Canine entropion]]
Entropion has been documented in most [[dog]] breeds, although there are some breeds (particularly [[purebred]]s) that are more commonly affected than others.  These include the [[Akita Inu|Akita]], [[Pug]], [[Chow Chow]], [[Shar Pei]], [[St. Bernard (dog)|St. Bernard]], [[Cocker Spaniel]], [[Boxer (dog)|Boxer]], [[English Springer Spaniel]], [[Welsh Springer Spaniel]], [[Labrador Retriever]], [[Cavalier King Charles Spaniel]], [[Neapolitan Mastiff]], [[Bull Mastiff]], [[Great Dane]], [[Irish Setter]], [[Shiba Inu]], [[Rottweiler]], [[Poodle]]&lt;ref name=Gelatt_1999&gt;{{cite book|editor=Gelatt, Kirk N.|title=Veterinary Ophthalmology|edition=3rd|publisher=Lippincott, Williams &amp; Wilkins|year=1999|isbn=0-683-30076-8}}&lt;/ref&gt; and particularly [[Bloodhound]]. 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.&lt;ref&gt;{{cite news| url=https://www.bbc.co.uk/news/uk-england-shropshire-15409182 | work=BBC News | title=Blind dog Lily and faithful chum Maddison seek new home | date=21 October 2011}}&lt;/ref&gt;
[[File:Feline Entropion OS.jpeg|alt=Vet.ophthalmologist Yastrebov O. St.Peterburg, Russia|thumb|left|Feline entropion]]
Entropion has also been seen in [[cat]] breeds. Typically it is secondary to trauma or infection leading to chronic eyelid changes. It is also seen secondary to [[enophthalmos]]. Primary entropion might also be encountered: the [[brachycephalic]] breeds (mostly the [[Persian cat|Persian]]) and the [[Maine Coon]] are predisposed.&lt;ref&gt;{{cite journal|last=Williams|first=DL|author2=Kim|title=Feline entropion: a case series of 50 affected animals (2003-2008)|journal=Veterinary Ophthalmology|date=Jul–Aug 2009|volume=12|issue=4|pages=221–226|pmid=19604337|doi=10.1111/j.1463-5224.2009.00705.x}}&lt;/ref&gt;&lt;ref&gt;{{Cite journal |last1=Bott |first1=Matthieu MP |last2=Chahory |first2=Sabine |date=2022-03-08 |title=Epidemiology and clinical presentation of feline presumed hereditary or breed-related ocular diseases in France: retrospective study of 129 cats |journal=Journal of Feline Medicine and Surgery |volume=24 |issue=12 |pages=1274–1282 |doi=10.1177/1098612x221080598| pmid=35257624 |s2cid=247294503 |issn=1098-612X|pmc=10812340 }}&lt;/ref&gt;

Upper-lid entropion involves the [[eyelash]]es rubbing on the eye, but the lower lid usually has no eyelashes, so little or no hair rubs on the eye. [[Surgery|Surgical]] 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]] muscle parallel to the affected portion of the lid and then the skin is [[surgical suture|suture]]d. 

Alternative techniques such as the Wyman technique focus on tightening the lower eyelid. This technique is not as effective in cases of enophthalmos.&lt;ref name=Bojrab&gt;{{cite book|last=Bojrab|first=M Joseph|title=Current techniques in small animal surgery|year=1998|publisher=Williams &amp; Wilkins|isbn=0-683-00890-0}}&lt;/ref&gt;
[[Shar Pei]]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.&lt;ref name=Gelatt_1999/&gt;

==See also==
* [[Ectropion]]

== References ==
{{Reflist}}

== External links ==
{{Medical resources
|  DiseasesDB     = 29643
|  ICD10          = {{ICD10|H|02|0|h|00}}, {{ICD10|Q|10|2|q|10}}
|  ICD9           = {{ICD9|374.0}} 
|  ICDO           = 
|  OMIM           = 
|  MedlinePlus    = 001008
|  eMedicineSubj  = oph
|  eMedicineTopic = 212
|  MeshID         = D004774
}}
* [https://medlineplus.gov/ency/article/001008.htm Medline Plus - Entropion]

{{Eye pathology}}
{{Congenital malformations and deformations of eye, ear, face and neck}}

[[Category:Dog diseases]]
[[Category:Congenital disorders of eyes]]
[[Category:Disorders of eyelid, lacrimal system and orbit]]