This is an inversion of the eyelid. The common form is the inversion of the lower eyelid seen in elderly patients. Often, the patient does not notice that the eyelid is turned in but complains of soreness and irritation. Closer inspection reveals the inverted eyelid, which can be restored to its normal position by slight downward pressure on the lower eyelid, only to turn in again when the patient forcibly closes the eyes. The inwardly turned eyelashes tend to rub on the cornea and, if neglected, the condition can lead to corneal scarring and consequent loss of vision. The condition is often associated with muscular eyelids and sometimes seems to be precipitated by repeatedly screwing up the eyes. Slackening of the fascial sling of the lower eyelid with ageing combined with the action of the orbicularis muscle allows this to happen. This common type of entropion is called spastic entropion and it can be promptly cured without leaving a visible scar by minor eyelid surgery. Entropion can also be seen following scarring of the conjunctival surface of the eyelids and one must mention, in particular, the entropion of the upper eyelid caused by trachoma. This is rare in the UK but still common in the Middle East and countries where trachoma is still rife.
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