ENTROPION

WHAT IS ENTROPION ?

Entropion causes the eyelid to turn or roll inwards. It then rubs against the eyeball and causes irritation.   It usually affects the lower eyelid.  

THE OPERATION

The aim of the treatment is to return the eyelid to its normal position. An incision is made just beneath the eyelashes on the lower eyelid.   We look for the muscle and then return it to its normal position.   Absorbable sutures are used.  

We usually slightly over-correct the eyelid during the operation, meaning that at first your eyelashes will turn outwards slightly too much.   Our experience has shown that the eyelid turns slightly inwards again of its own accord.  

The skin is secured using non-absorbable sutures which are then removed a week later by a doctor.   

Before the operation

10 days before the operation

Anticoagulants

You must stop taking anticoagulants 10 days before the operation. However, before stopping, you must consult your doctor and check that he or she agrees that it is safe to do so. If you are taking MARCOUMAR you will be offered a plan so that you can take an alternative drug as a replacement. Your doctor will be consulted about this to make sure that he or she agrees. If anticoagulants prescribed for a general illness cannot be stopped, it is possible that the eyelid surgery will not be able to go ahead.

The day before the operation

• Go to the chemist and buy a cooling mask (ice pack).
• Make sure that you have some paracetamol (pain killers).

The day of the operation

You may eat as normal on the day of the operation. Take all of your medication as usual (except for the anticoagulants).

Do not wear any mascara, make-up, earrings or necklaces. Wear comfortable clothes. Do not wear your contact lenses.

Bring some recent (representative) photographs of yourself with you.   You will be photographed before and after the operation so that you can judge the results for yourself.

Tell the doctor or nurse if you are allergic to any medicines.

The operation will last approximately 45 minutes. If it has taken longer than expected to treat the patients before you, you will also have to allow for waiting time.

During the operation

The whole of your face will be disinfected with Isobetadine and sterile tissues will be placed around your face like a turban. Your nose and mouth will still be free so that you can breathe normally.

During the operation you will not be able to touch your face. This is because it needs to be kept sterile.

The doctor will then give you subcutaneous (i.e. under the skin) injections (lidocaine 2% with adrenalin 1: 100,000). These injections are similar to the injections you have at the dentist. The anaesthetic will start to work immediately and will last for approximately one hour.

During the operation you will have to sit up a few times so that the doctor can judge the results more effectively.  

At the end of the operation an antibiotic ointment will be applied to your eyelids. You will then get a cooling mask that you will have to leave on your eyes for half an hour. When you go home, it is important that you use the cooling mask every hour for 10 minutes.   Alternatively, you can use a packet of frozen peas because they will mould to your face easily. This cooling is very important as it helps to reduce the swelling, but it is only effective during the first 24 hours after the operation. If this causes pain, you can take some paracetamol (as this does not contain any anticoagulant substances).

The day after the operation

Cool your eyelids with ice (3 times). You will notice that the swelling gets worse up until the third day after the operation and then it will start to get better thereafter.

The first week after the operation

It is possible that your skin will be blue for about a week. The swelling can last for up to three weeks. Don't worry about any haematomas (blood clots under the skin), as these will gradually disappear.

While you still have the sutures, you must not get any water on your eyes. You are also advised not to wear any make-up. Do not massage your eyelids in any way during the first three weeks. Do not put any dressings on your eyelids.

Removal of the sutures and check-up  

The sutures will be removed 5 to 7 days after the operation. Once they have been removed, you may use water on your eyelids again. You will have another check-up 4 weeks after the operation.

The first three months after the operation

Stay out of the sun as it can cause nasty scars. You can avoid it by using total sun block (factor 60) or by wearing a hat. Sunglasses do not offer you sufficient protection.

SIDE EFFECTS AND COMPLICATIONS

Scars

The scar may be red and sensitive for a few months.   Subcutaneous cysts may also develop in reaction to the sutures that have been used.   These will go away of their own accord.  

Eye irritation

You may notice that you experience dry eye syndrome for a time.   You can use eye drops to combat this.  

Reoccurrence – eyelashes turning inwards again

After a few years, it is possible that your eyelashes will start to turn inwards again. If this happens, we can operate using the same incision as previously.