Formula Medical Group
Apple Valley, CA

James Krider, MD

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Eyelash abnormalities

What are eyelash abnormalities?

The two most significant eyelash abnormalities are called entropion and ectropion. Entropion is a turning in, or inversion, of the eyelashes, in which the lashes rub against the eyeball. Ectropion is an outward turning of the eyelashes in which the eyelid and lashes hang down abnormally.

Although these conditions are referred to as eyelash abnormalities, they result primarily from abnormal positioning of the eyelid, generally the lower one.

What causes eyelash abnormalities?

The primary cause of entropion and ectropion is aging. With advancing age, the skin and underlying tissues that surround the eye begin to relax. These changes can pull the lower eyelid into an abnormal position.

In entropion, such relaxation may permit the muscles in the


  • Abnormal positioning of the eyelashes and eyelid.
  • Eye redness.
  • Eye irritation.
  • Watery eyes.
  • Discharge of tears unrelated to crying.

lid margin to contract excessively, pulling toward the eye. In ectropion, such relaxation causes sagging in the muscles that normally keep the lower lid taut as it rests against the eyeball.

Sometimes, entropion may be triggered by other causes, such as chronic conjunctivitis, leading to scarred and improperly functioning lid margins. A scar on the lower lid or cheek may pull the eyelid downward and can also cause ectropion.

How are eyelash abnormalities diagnosed and treated?

Both the patient and doctor can easily observe these abnormalities. Treatment

In ectropion, the lower eyelid hangs down abnormally, exposing the conjunctivia and disrupting the normal flow of tears.

In ectropion, the lower eyelid hangs down abnormally, exposing the conjunctivia and disrupting the normal flow of tears.

depends on the condition and its severity. In some cases of entropion, self-help measures provide adequate relief, but in others, surgery is warranted. Ectropion usually requires surgery.

What can I do myself?
Self-care measures can sometimes correct entropion. These involve using a small piece of masking or surgical tape to keep the eyelid in its proper position. After thorough hand washing, use the fingers to turn the lid outward; then keep it turned outward by attaching one end of the tape to the skin just below the lower lashes and the other end to the cheek. Maintain this taping for several days, during both waking and sleeping hours. Then remove the tape. Sometimes, the condition will have corrected itself. If it has not or if it recurs, a doctor should be consulted.

When should I see my doctor?

Any persistent eye irritation or abnormal tear production warrants investigation.

What will the doctor do?
A physician will probably refer a patient with these abnormalities to an ophthalmologist. Surgical correction is usually needed if the condition is severe enough to damage the eye or cause excessive irritation.

Operations to correct entropion or ectropion are minor procedures, usually performed on an outpatient basis and with local anesthesia. The operation

tightens the muscles and tissues supporting the eyelid and leaves no obvious scars.

The course of eyelash abnormalities

While entropion is sometimes only a temporary condition that resolves by itself (or with the help of a piece of tape), it usually requires surgical correction. Ectropion never resolves spontaneously and, if severe, it invariably warrants surgical correction. An inward-turning eyelid causes irritation as the lashes rub against the cornea and conjunctiva, which are the outermost parts of the eyeball. This constant scratching of the eye's surface causes redness and tearing and may set the stage for conjunctivitis, or inflammation of the membrane that covers the eyeball. Untreated conjunctivitis can, in turn, cause corneal ulceration and scarring. In the worst cases of persistent, untreated entropion, vision may be impaired due to permanent damage to the cornea.

If the eyelash turns outward, tears cannot pass normally through the system of ducts that drains the eye. Instead of draining through a tiny channel at the inner corner of the eye, tears may spill over the center of the lower lid and down the cheek. Further, because the eyelid falls away from the eye, the conjunctiva is abnormally exposed, which can (as in entropion) promote development of corneal ulcers that may damage the eye permanently and result in a loss of vision.

Are eyelash abnormalities dangerous?
Normally, no, as long as they are treated promptly.

What can I do to avoid eyelash abnormalities?

  • Get prompt treatment for any eye irritation, especially conjunctivitis.
  • Any injury near the eye, such as a severe cut below the lid, requires medical attention to help prevent scarring.

In entropion, the eyelid turns inward and the eyelashes rub against the eyeball.

In entropion, the eyelid turns inward and the eyelashes rub against the eyeball.
This article was last reviewed November 27, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Conjunctivitis, chronic
Ulcer, corneal
Vision loss

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