🎧MSRA Podcast:Entropion — When Eyelashes Turn Against You

Welcome to the DeepDive. Today we’re looking at entropion, adeceptively simple but important topic for MSRA revision and real-life generalpractice. This eyelid condition might seem minor at first glance, but leftuntreated it can lead to corneal damage andvision loss.

👁️What Is Entropion?

Entropion is whenthe eyelid margin turns inward, typicallythe lower lid, causing eyelashes to rub against the cornea and conjunctiva.

Key symptomsinclude:

• Foreign body sensation

• Tearing (epiphora)

• Redness and irritation

• Photophobia and possible blurred vision

💡Mnemonic for Causes —A-S-T-I-C-T-B:

• Ageing — most common cause

• Scarring (from surgery, trauma, or infection)

• Trauma

• Inflammatory eye conditions

• Congenital (present from birth)

• Trachoma

• Bell’s palsy (7th nerve palsy)

🧠Risk Factors:

• Age >60

• Previous eye surgery

• Chronic blepharitis or conjunctival scarring

• Neurological disorders (e.g., facial nervepalsy)

📊Epidemiology (UK):

• More common in older adults

• Exact prevalence unclear, but frequentlyencountered in ophthalmic practice

🔬Pathophysiology:

• Inward rotation ofthe eyelid causes lashes to chronically abradethe cornea

• Can lead to corneal abrasion, ulceration, and potentially vision-threateningcomplications

🩺DifferentialDiagnosis:

• Ectropion — outward turning of the eyelid

• Trichiasis — misdirected lashes with a normallid margin

• Spastic entropion — intermittent inward turningdue to orbicularis spasm

• Other causes ofred or irritated eyes, including blepharitis,foreign body, or conjunctivitis

🧪Diagnosis:

• Primarily clinical, no advanced tests needed

• Key signs: Inward-turning lid, lashes contacting the globe, cornealstaining with fluorescein

• Use a slit lamp if available to detect subtle cornealdamage

💊Management(MSRA-aligned):

Conservative (mild cases):

• Lubricating drops/ointment

• Taping the eyelid outward

• Protective eyewear

• Temporary measureslike botulinum toxin if needed

Surgical (persistent/moderate-severe cases):

• Definitive treatment

• Techniques vary —usually involve tightening and repositioningthe lower lid

• Aims to preventfurther abrasion or ulceration

⚠️Complications (IfUntreated):

• Corneal abrasions

• Corneal ulcers and scarring

• Conjunctivitis

• Permanent vision loss if corneal damage issignificant

📈Prognosis:

• Generally excellent if treated early

• Surgical correction is highly effective

• Delays intreatment increase risk of complications

🧠MSRA Key SummaryPoints:

• Entropion = inward eyelid turn

• Causes eye irritation, foreignbody sensation, watering, and potential corneal damage

• Diagnosed clinically — watch for inward lashes rubbing the eye

• Treatconservatively (drops/tape) or surgically (if persistent/severe)

• Remember ASTICTB for causes

• Prognosis is goodwith early management

📚Entropion MSRARevision Resources:

📝 Revision Notes:

https://www.passthemsra.com/topic/entropion-revision-notes/

🃏 Flashcards:

https://www.passthemsra.com/topic/entropion-flashcards/

📖 Accordion Q&A Notes:

https://www.passthemsra.com/topic/entropion-accordion-qa-notes/

🧠 Rapid Quiz:

https://www.passthemsra.com/topic/entropion-rapid-quiz/

🎯 Direct Quiz Link:

https://www.passthemsra.com/quizzes/entropion/

🌐Explore MoreHigh-Yield Resources:

https://www.passthemsra.com

https://www.freemsra.com

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