Entropion and ectropion repair

Symptoms of entropion include:

• Red eyes
• Blurred vision
• Pain
• Itching
• Watery eyes
• Feeling like there's something in your eye
• Sensitivity to external stimuli such as light or wind
• Crusts forming around the eye

Symptoms of ectropion include:

• Sore, red, or irritated eyes
• Dry eyes
• A feeling of grit in your eye
• Excessive watering
• Frequent eye infections

Entropion and ectropion are normally associated with ageing and are more common in people over sixty years of age. This is because the muscles that control the eyelids weaken as we age.

Entropion may also be caused by:

• Scarring
• Previous eye infection, injury, or surgery

Ectropion may also be caused by:

• Problems with the nerves that control the eyelids such as in conditions like Bell's palsy (facial paralysis)
• Damage to the skin around the eyelid due to infection, injury, or surgery
• A cyst, lump or tumour on the eyelid

At your first consultation, you will be seen by a consultant ophthalmologist, a doctor specialising in conditions affecting the eye. Your consultant will ask you about your symptoms, general health, and medical history. They will also examine your eye. This is all to make a diagnosis.

At Circle Health Group, your first appointment is very important as it's where we begin to get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so please ask your consultant any questions you may have.

After making a diagnosis, your consultant will decide whether an entropion or ectropion repair is suitable for you based on your symptoms and diagnosis.

Your consultant will tell you everything you need to do to prepare for your surgery. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.

Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, try to stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

Entropion and ectropion repair are normally carried out using local anaesthetic. This means you'll be awake for the procedure but won't feel any pain. The local anaesthetic is injected into your eyelid to numb the area and then local anaesthetic eye drops are put into your eye.

You will need to lie flat and keep still during the operation. If this is difficult for you, please let your consultant know beforehand.

Once the anaesthetic has taken effect, your consultant will remove a small section of your eyelid where the skin is loosest. If there is tightening of the skin or scar tissue, these will be removed, and your consultant may need to use a skin graft to replace the removed tissue. Your consultant will then close the area with stitches.

Entropion or ectropion repair normally takes around 30 minutes per eye.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery.

Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your surgery, you will remain in the department for a few hours until you are ready to be discharged.

How many nights will I need to stay in hospital?

Entropion and ectropion repair are normally done as a day case, meaning you'll be able to go home later the same day.

Will I be able to drive home?

You will not be able to drive yourself home from the hospital after your entropion or ectropion repair. Please make arrangements for someone to come and collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

You can go back to work when you feel ready after your surgery. Avoid strenuous exercise and bending until your stitches are removed (normally around a week after your surgery). Most people return to work around a week to ten days after their entropion or ectropion repair, though you may still have some visible bruising around your eyes at this time.

How soon can I drive?

You can drive when your eyes feel comfortable and you can see normally without any blurring or double vision. This is normally a day or two after your surgery.

When will I be back to normal?

Recovery from entropion and ectropion repair is a gradual process that is different for everyone.

You may experience some mild pain and discomfort and your eyelids may be bruised and swollen for a week or two after your operation. Your consultant may prescribe eye drops to help relieve inflammation and reduce the risk of infection. You can also use cold compresses on your eyes to relieve pain and swelling. Take over-the-counter painkillers like paracetamol and ibuprofen if you need to.

Avoid getting your eyelid wet until the stitches are removed in about a week. Don't drink alcohol, wear eye make-up, or expose your face to the sun for a few weeks after your surgery.

Gentle exercise, like walking, is encouraged after your surgery, but check with your consultant when you can start more vigorous exercise after your operation.

Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision so please ask any questions you may have.

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clots
• Adverse reactions to the anaesthetic

Possible complications specific to entropion and ectropion repair include:

• Blurred or double vision - this is due to the eye drops, and ointments used during the operation and normally resolves within forty-eight hours
• Corneal abrasions (scratches on the cornea)
• Eyelid notch - a deformity or notch in the lower eyelid margin
• Aesthetic problems - your eyes may appear asymmetrical after surgery, though your consultant will try their best to avoid this. Any asymmetry normally improves over time as your eyelids heal
• Scarring or thickening of the skin graft - scarring is normally minimal, but thicker scars can develop due to infection or poor wound healing. This may need to be treated with steroid injections or the application of silicone gel
• Eyelid lumps - lumps can develop on the eyelid as a reaction to the stitches. These normally go away by themselves, but rarely, may require steroid injections

The only permanent treatment for entropion and ectropion is surgical repair. If you do not want, or cannot have surgery, there are some short-term solutions available including:

• Artificial tears and ointments to protect and lubricate your eyes
• Using tape or stitches to hold your eyelids in place and prevent them from turning inwards
• Soft contact lenses to protect your eyes and reduce irritation
• Botox injections can weaken the muscles in your eyelid and prevent them from turning inwards

We answer some of your most commonly asked questions about entropion and ectropion repair.

Can entropion cause blindness?

Untreated entropion can cause corneal abrasions and scarring which can lead to vision loss or even blindness.

Can entropion return after surgery?

Rarely, entropion can return several months or even years after surgery. This is because the eyelid muscles get weaker over time. In most cases entropion repair surgery is successful, and the condition is unlikely to return.

How long does entropion surgery take?

Entropion surgery normally takes around 30 minutes per eye.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about entropion and ectropion repair, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in May 2023. Next review due May 2026.

1. Ectropion, NHS
2. Entropion, Cleveland Clinic
3. Entropion and entropion repair, Health Direct