Entropion is a condition common in older adults that causes the eyelid to turn inward. It typically affects the lower eyelid and can cause the eyelashes to be up against the eye, which can cause irritation to the eye and even potentially damage the cornea. (Learn More)

In mild forms the condition can be managed with nonsurgical options, such as Botox injections, transparent tape, contacts, and eye drops, but the only way to potentially reverse entropion is through surgery. (Learn More) Entropion costs can vary from several hundred to a few thousand dollars, depending on the severity and type of surgery needed. (Learn More)

Specific forms of entropion surgery are performed based on the underlying cause of the condition and its severity. (Learn More)

There are risks for any type of surgery, and it is important to take care of yourself after the procedure. (Learn More) Your eye doctor can walk you through treatment options.

two asian seniors

Causes of Entropion

Entropion is a condition that impacts the lower eyelid. It occurs when the eyelid is turned in and causes the eyelashes to be pushed up against the eye. The eyelid can be constantly turned in or only when you close your eyes or blink hard.

Mayo Clinic reports that entropion is most common in older adults, as it is often caused by a weakening of muscles and stretching of tendons under the eye. Entropion can also be a congenital (birth) disorder that may resolve itself in the first year of life. Congenital entropion is typically not treated surgically as a result.

Trauma, including eye infections, previous eye surgeries, burns, and scarring, can also cause entropion. Spastic entropion can be caused by eyelid muscle spasms related to inflammation of the eye, which can be treated with eye drops and methods for relieving inflammation.

The Need for Surgery

man rubbing eyes

Symptoms of entropion can be temporarily relieved by using transparent tape on the eyelid to turn it the right way, lubricating eye drops, a soft contact to protect the cornea from being scratched or irritated by the eyelashes, Botox injected into the lower eyelid, or stitches places in the eyelid to turn it outward. All of these are temporary solutions, and surgery is often the optimal course of action for entropion.

If you experience any of the following related to entropion, you may wish to seek out surgery for a long-term fix:

  • Red, irritated eyes
  • Feeling like something is in your eye
  • Sensitivity to wind and light
  • Eye pain
  • Watery eyes
  • Crusting on the eyelid and mucus discharge
  • Decreasing vision

Left untreated, entropion can injure the cornea, potentially leading to corneal ulcers, eye infections, and vision loss. Typically, surgery is deemed the most common long-term solution to entropion.

Expected Costs of Entropion Surgery

The cost of entropion surgery is going to depend on the type of surgery you receive, where you have the procedure done, how complex the procedure needs to be, and the degree of entropion. Entropion surgery is typically done by an ophthalmologist, ophthalmologist surgical specialist, or oculoplastic surgeon.

Costs for the procedure can range from around $500 to $2,000. Additional costs, including anesthesia fees, costs associated with necessary medications, tests and examination fees prior to surgery, aftercare appointments, and hospital fees, can also be incurred.

Insurance will often cover at least a portion of entropion surgery since it is most commonly determined to be a medically necessary procedure. Contact your insurance provider to find out what your out-of-pocket costs might be.

Types of Entropion Surgery

Entropion surgery is typically an outpatient surgery that can be performed at an ophthalmologist's office, a surgery center, or a hospital. It generally takes under an hour to complete and can be managed with local anesthesia.

There are multiple forms of entropion surgery that can be performed based on the level of entropion and cause of the condition.

  • Everting sutures: Everting means to turn something inside out. In this case, it means to turn the eyelid right side out. It is a relatively fast procedure that uses stitches inside the eyelid to stiffen it up and keep it from turning in to irritate the eye. Numbing drops are put into the eye while you are laying down, and the stitches are placed in a matter of minutes. The stitches will typically be dissolvable and not need to be taken out. Entropion may return in time with this procedure.
  • Quickert procedure: This option is a little more in depth. It is often used after everting stitches and a reoccurrence of entropion. It involves cutting the ends of the eyelid, removing a small piece, and then reattaching the cut ends to tighten the lid. Dissolvable everting stitches are also used. This procedure takes about 45 minutes and involves more recovery time, but the entropion usually doesn't come back.
  • Jones procedure: This procedure is typically reserved for people who have already had an entropion surgery, and it has returned. Deep stitches are placed into the lower lid retractor (the muscle that opens the lid) to tighten it after the skin of the lid is cut for access. The deep stitches may be permanent or dissolvable, and the procedure typically takes about 45 minutes to complete.
  • Lateral tarsal strip: With this procedure, the eyelid is tightened by using deep stitches to attach the outside corner of the lid to the tissue over the bone of the eye socket. This tightens the eyelid horizontally to correct entropion. It takes about 45 minutes to complete the procedure. The deep stitch can come loose in time, resulting in a return of entropion.

Lateral tarsal strip and everting suture procedures can be combined with positive outcomes as well.

Your eye doctor will perform thorough eye and medical examinations to determine which procedure will be best suited for you.

Smiling mature patient consulting with optometrist for an eye checkup

Possible Side Effects & Aftercare

All surgeries have risks, including possibility of infection, scarring, bleeding, and allergic reaction. The entropion can return, and vision may be impacted by surgery.

You will likely experience some discomfort, swelling, and bruising after surgery that will subside in a few days. The stitches may irritate the eyes, but this is not common. You may not be able to drive or do anything strenuous for a few days after entropion surgery.

Surgical risks can be minimized by following all of your doctor’s directions and recommendations both before and after surgery. For example, you will likely need to stop smoking and taking certain medications (such as those that can increase the odds for bleeding) for a few weeks before and after surgery.

After entropion surgery, your doctor may give you antibiotic cream and/or eye drops to use. You can ease swelling and discomfort by icing or using a cool compress for the first 48 hours after surgery and then switch to warm compresses. Keep your head elevated, even during sleep.

The bruising and swelling can take up to two weeks to heal completely. Your eyelid may feel tight immediately following surgery, but this will ease with time. If your stitches are dissolvable, you won't need to have them removed; otherwise, you may need a removal appointment about a week after surgery.

Ultimately, surgery can offer a long-term solution for entropion and a relief of symptoms.

References

Entropion. Symptoms and Causes. (January 2019). Mayo Clinic.

Entropion. Diagnosis and Treatment. (January 2019). Mayo Clinic.

Eyelid Disorders/Entropion and Ectropion. (April 2010). National Eye Institute (NEI).

Surgical Management of Entropion. (October 2010). Ophthalmologe.

Patient Information Fact Sheet. Entropion. (January 2015). NHS.

Diagnosis and Management of Involutional Entropion. (February 2016). American Academy of Ophthalmology (AAO) EyeNet Magazine.