Entropion: Symptoms, Causes, and Treatment

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

A healthy eyelid compared with entropion, where the lower eyelid has rolled inward and the lashes rub against the eye surface.

Quick Answer: What is entropion?

Entropion is a condition in which the eyelid, most often the lower one, turns inward so lashes and skin rub the eye surface. It causes a feeling of something in the eye, redness, irritation, light sensitivity and watery eyes. Aging-related eyelid weakness is the most common cause. It is usually treated with surgery that tightens the eyelid. [1] [2]

What the research says

According to PubMed:

• Combined surgery works better than sutures alone. A Cochrane review found one randomized trial that met its criteria: 63 people over 60 with involutional lower-lid entropion were assigned to everting sutures alone or everting sutures plus a lateral tarsal strip. The combined procedure, which tightens the lid both horizontally and vertically, was highly curative compared with sutures alone, though the authors noted that one trial is unlikely to change practice (Boboridis and Bunce, Cochrane Database Syst Rev, 2011; DOI).

• Botox can be a stopgap for frail patients. In a retrospective study of 50 elderly patients (average age 87.9 years) with spasmodic entropion who could not have eyelid surgery, the condition resolved within about 3 days of an injection, and re-injection was needed on average every 4.25 months, with no systemic complications reported (Girard et al., Toxins, 2025; DOI).

• Scar-related entropion needs a different fix. A 2025 narrative review of 115 publications concluded that cicatricial entropion, which comes from contraction of the inner eyelid layer after inflammation or injury, is best treated with lamellar repositioning or grafting procedures (Quaranta Leoni et al., J Clin Med, 2025; DOI).

Study details are from PubMed abstracts.

Key facts at a glance

Fact	Detail
What it is	The eyelid, usually the lower one, turns inward, rubbing lashes and skin on the eye surface [1]
Who it affects	More common in older adults [1]
How it behaves	May be constant, or appear only when blinking hard or squeezing the eyes shut [1]
Main cause	Aging weakens the muscles and tendons that hold the eyelid against the eye [1]
Without treatment	Corneal damage, eye infections, and vision loss are possible [1]
Full correction	Usually requires surgery [2]
Symptom relief	Artificial tears and lubricating ointments help protect the eye [2]

What entropion is

Entropion is a condition in which the eyelid turns inward so that the eyelashes and skin rub against the surface of the eye. The condition most often involves the lower eyelid, and it may keep the lid turned in all the time or only when the person blinks hard or squeezes the eyelids shut. [1]

The constant friction irritates the eye. While drops and ointments can soothe symptoms, surgery is usually required for a full correction. Untreated entropion can damage the cornea, cause eye infections, and lead to vision loss. [1] [2]

Six signs of entropion. Seek immediate care if redness worsens fast, pain appears, light sensitivity grows, or vision drops, which are signs of cornea injury.

Symptoms: signs that the lid is turning in

The signs and symptoms of entropion come from the friction of the eyelashes and the outer eyelid against the surface of the eye: [1]

Symptom	What it looks like
Something in the eye	A persistent feeling that something is in the eye
Eye redness	The eye looks red and irritated
Irritation or pain	The eye is uncomfortable, aches, or hurts
Sensitivity to light and wind	Bright light and wind feel uncomfortable
Dry or watery eyes	Dryness, or excessive tearing
Discharge and crusting	Mucous discharge and crusting along the eyelid

When to see a doctor

See a healthcare professional if an eyelid is turned inward or the eye is constantly irritated. Leaving entropion untreated too long can cause permanent eye damage, so protecting the eye with artificial tears and lubricating ointments before the appointment is sensible. [1]

Seek immediate care for eye pain or achiness, pain that worsens with light, or decreased vision, because these can signal serious injury to the cornea. [1]

Causes: why the eyelid turns inward

Cause	How it works
Muscle and tendon weakness	With age, the muscles and tendons that hold the eyelid against the eye weaken. This is the most common cause of lower-lid entropion.
Scars	Scarring from injury, infection, surgery, or long-term inflammation can pull the eyelid inward, and often affects the upper eyelid.
Muscle spasms	Eye irritation, infection, or eye surgery can trigger spasms of the eyelid muscle that roll the lid inward. These may come and go.
Glaucoma medicines	Long-term use of certain glaucoma medicines is a listed cause.
Present at birth	Rarely, entropion is a congenital condition.

Risk factors and complications

The older a person is, the greater the chance of entropion. Scar tissue from a facial burn or injury raises the risk, and trachoma, an eye infection that scars the inner eyelids, can increase the risk as well. [1]

Corneal irritation and injury are the most serious complications. Rubbing can scratch the cornea, thin it, cause ulcers, ongoing inflammation, and abnormal blood vessel growth, and may lead to vision loss. [1]

How entropion is diagnosed

Entropion can usually be diagnosed with a routine eye exam. The doctor may pull on the eyelids or ask the patient to blink or close the eyes forcefully, which helps assess the eyelid's position on the eye, its muscle tone, and its tightness. If scar tissue, previous surgery, or another condition may be involved, the doctor will examine the surrounding tissue as well. [2]

The entropion pathway from diagnosis, through eye protection and short-term fixes, to surgery.

Treatment options

The treatment approach depends on what is causing the entropion. Nonsurgical treatments can relieve symptoms and protect the eye from damage. Surgery is generally required to fully correct entropion, but short-term fixes help when surgery must be delayed. [2]

Nonsurgical options

Therapy	How it works
Artificial tears and ointments	Lubricate and protect the cornea from the rubbing lashes
Soft contact lens	Acts as a barrier that protects the cornea
Botox injections	Small amounts injected into the lower eyelid turn the lid outward; the effect may last several months, and repeat injections may be needed
Stitches that turn the eyelid outward	Placed in the doctor's office; the effect can last several months, so this is not a long-term solution
Skin tape	Special transparent tape applied to the eyelid keeps it from turning in

Surgery

The type of surgery depends on the condition of the tissue surrounding the eyelid and on the cause of the entropion. Common steps include removing a small amount of tissue and muscle and using sutures to pull the eyelid outward, removing scar tissue, and sometimes grafting tissue taken from the roof of the mouth or the nasal cavity to rebuild the inner lid. [2]

After surgery, care can include wearing an eye patch for 24 hours, using antibiotic and steroid ointment, applying cold compresses, limiting activity for the first week, avoiding eye rubbing, and avoiding contact lenses for two weeks. Your surgeon will give instructions specific to your procedure. [2]

Home care while waiting

• Eye lubricants. Artificial tears and eye ointments protect the cornea and keep it lubricated.

• Skin tape. Transparent tape keeps the lid from turning in. Ask the doctor to demonstrate proper technique and placement.

Preparing for your appointment

Entropion care usually starts with a primary care doctor, who may refer you to an ophthalmologist, a doctor who specializes in eye disorders. Before the appointment, make a list of all medications, vitamins, and supplements with doses, your symptoms and how long they have been happening, other eye conditions, injuries, or surgeries, and your questions. [2]

Expect questions about when symptoms began, whether they are continuous or occasional, any previous eye surgery or procedures, other eye problems such as infections or injuries, and current use of blood thinners, aspirin, or eyedrops. [2]

Conclusion

Entropion is a quiet troublemaker: the eyelid rolls in, the lashes rub the eye, and the discomfort can build toward corneal damage that affects vision. It is most often the result of normal aging of the tissues that hold the eyelid in place, and it is very treatable. Artificial tears and lubricating ointments protect the eye right away, several short-term fixes buy time, and surgery usually provides a full correction. [1] [2]

Next steps: If the eyelashes seem to be turning inward or the eye constantly feels irritated, make an appointment with a doctor, and protect the eye with artificial tears and lubricating ointments in the meantime.

Frequently asked questions

Is entropion curable?

Entropion is usually fully correctable with surgery, which tightens the eyelid or, when scarring is the cause, uses a tissue graft. Nonsurgical options such as Botox, in-office stitches, skin tape, and a soft contact lens can manage symptoms in the short term. [2]

What causes entropion?

The most common cause of lower-lid entropion is aging, which weakens the muscles and tendons that hold the eyelid against the eye. Scarring from injury, infection, surgery, or long-term inflammation, muscle spasms triggered by eye irritation, infection, or eye surgery, long-term use of certain glaucoma medicines, and, rarely, a condition present at birth can also cause it. [1]

Can entropion damage my vision?

Left untreated, rubbing from the lashes can scratch and thin the cornea, cause ulcers, and lead to vision loss. Eye pain or achiness, pain that worsens with light, or decreased vision can signal serious corneal injury and need immediate care. [1]

Does entropion go away on its own?

Not usually. Entropion caused by muscle spasms may come and go, but entropion from aging or scarring tends to persist, and surgery is generally needed for a lasting correction. [1] [2]

What is the difference between entropion and ectropion?

Entropion is an inward-turning eyelid, where lashes and skin rub the eye surface. Ectropion is the opposite: an outward-turning eyelid. They have different causes and different treatments.

This article is for general education and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about your individual situation.

References

1. Mayo Clinic Staff. Entropion - Symptoms and causes. Mayo Clinic. September 19, 2026. https://www.mayoclinic.org/diseases-conditions/entropion/symptoms-causes/syc-20351125

2. Mayo Clinic Staff. Entropion - Diagnosis and treatment. Mayo Clinic. September 19, 2026. https://www.mayoclinic.org/diseases-conditions/entropion/diagnosis-treatment/drc-20351131

3. Boboridis KG, Bunce C. Interventions for involutional lower lid entropion. Cochrane Database Syst Rev. 2011;(12):CD002221. PMID 22161369. https://doi.org/10.1002/14651858.CD002221.pub2

4. Girard B, Carré F, Begnaud S. Botulinum neurotoxin A injections in spasmodic entropion: a clinical retrospective cohort study. Toxins (Basel). 2025;17(8):383. PMID 40864059. https://doi.org/10.3390/toxins17080383

5. Quaranta Leoni FM, Marabottini N, Iuliano A, et al. Eyelid malpositions and ocular surface disease: clinical correlations and management strategies. J Clin Med. 2025;14(23):8523. PMID 41375826. https://doi.org/10.3390/jcm14238523