Inward eyelid retraction in children symptoms causes and treatment

Inward turning of the eyelid (entropion) in children is a common condition that causes discomfort for the child and concern for parents. It makes the eyelashes rub against the surface of the eye, leading to tearing, redness, and sometimes repeated infections. This problem can appear from birth or develop later as the child grows. If left untreated, it may affect vision over time. In this Dailly Medical guide, we’ll explore together the main causes of entropion in children, the symptoms parents should watch for, how doctors diagnose and treat it, and the most important prevention tips to protect your child’s eye health.

1. What is entropion in children?

Entropion is a condition where the edge of the eyelid turns inward, causing the eyelashes to rub against the surface of the eye. This leads to constant tearing and redness.

2. Is entropion dangerous?

If left untreated, it can cause corneal scratches or ulcers, which may eventually affect vision.

3. Can a child be born with entropion?

Yes, most cases are congenital, meaning the child is born with it.

4. Can entropion improve without surgery?

Mild cases may improve as the child grows, or with the use of lubricating drops and temporary eyelid taping.
But most moderate to severe cases require surgery for permanent correction.

5. What are the symptoms of entropion in children?

Constant tearing.
Redness of the eye.
Frequent eye rubbing.
Light sensitivity (photophobia).
Recurrent discharge or infections.
Feeling of a foreign body in the eye.

6. How is entropion diagnosed in children?

The doctor diagnoses the condition through direct examination of the eyelid and eye. Sometimes, a corneal exam is done to check for scratches or ulcers.

7. Is surgery for entropion risky for children?

No, it is a very simple procedure performed under general anesthesia for children, with a high and safe success rate.

8. Can laser be used to treat entropion in children?

Laser is not commonly used in children. The safest options are traditional surgery with fine sutures or eyelid tightening.

9. Can entropion come back after surgery?

It is very rare. If it does recur, it is usually milder and easily corrected with a secondary procedure.

10. How can parents protect their child from entropion or its complications?

Regular check-ups with a pediatric ophthalmologist.
Treating any eye infection quickly.
Preventing the child from rubbing their eyes.
Using lubricating drops when prescribed by the doctor.

11. Does entropion affect one eye or both?

It can affect one or both eyes, depending on the underlying cause.

12. Is there a difference between entropion in children and adults?

In children: it is mostly congenital (from birth).
In adults: it is usually acquired due to chronic inflammation or eyelid laxity with aging.

13. How to tell the difference between a blocked tear duct and entropion?

Blocked tear duct: excessive tearing down the child’s face without significant redness.
Entropion: tearing with redness, irritation, and lashes rubbing the eye.

14. Does entropion affect the child’s appearance?

The eyes may look red or slightly different, but after treatment, the appearance returns completely to normal.

15. Is entropion painful for children?

Yes, the child may feel like there is sand or a foreign body in the eye, leading to frequent rubbing or crying.

16. Are there herbal or natural remedies for entropion?

❌ No. Natural remedies cannot correct the cause. They may only reduce redness, but proper medical treatment is necessary.

17. When should I take my child to the doctor immediately?

Persistent tearing with redness.
Frequent eye rubbing.
Discharge or pus.
If you suspect poor vision or the child isn’t focusing properly.

18. Can surgery be delayed or must it be immediate?

Mild cases: the doctor may monitor with drops or taping temporarily.
Cases with corneal risk (scratches or ulcers): surgery should be done as soon as possible.

19. Will the child need more than one surgery?

Rarely. Most cases are corrected with a single surgery. If recurrence happens, it’s usually mild and fixed with a minor additional procedure.

20. Does the child need special care after surgery?

Yes, after surgery the child may need:

Anti-inflammatory and antibiotic eye drops.
Regular follow-up visits with the doctor.
Avoid rubbing the eyes or exposure to dust for a short period.

Causes of entropion in children

Congenital causes (from birth):

Defect in eyelid muscles or ligaments.
Short or tight skin around the eyelid.
Excess tissues or fat inside the eyelid.
Weak cartilage structure of the eyelid.

Acquired causes (develop later):

Recurrent eye or conjunctival infections.
Eye injuries or trauma.
Burns affecting eyelid tissues.
Complications after eye surgeries.

Rare but possible causes in children:

Skin diseases affecting eyelid elasticity.
Scarring after severe infections.

Symptoms of entropion in children

Constant tearing: from lashes rubbing the eye.
Frequent redness: due to continuous irritation.
Eye rubbing or itching: from discomfort.
Light sensitivity (photophobia).
Recurrent infections or discharge.
Feeling of a foreign body in the eye.
Vision problems if untreated: corneal scratches or ulcers may reduce clarity.

Types of entropion in children

Congenital entropion: present at birth, usually from muscle or skin defects.
Acquired entropion: develops later from infections, trauma, burns, or scarring. Rare in children but possible.
Partial entropion: affects part of the eyelid (inner or outer corner).
Complete entropion: affects the whole eyelid, more severe and uncomfortable.

Stages of entropion in children

Stage 1 (Mild beginning): eyelid turns inward slightly, seen during smiling or eye pressure. Mild tearing/redness.
Stage 2 (Increased friction): lashes rub against the eye, more tearing, light sensitivity, frequent rubbing.
Stage 3 (Inflammation/irritation): persistent redness, discharge, sensation of sand in the eye.
Stage 4 (Corneal complications): surface scratches, possible ulcers, vision weakness if untreated.

Risks of untreated entropion

Persistent eye irritation.
Chronic conjunctivitis.
Painful corneal scratches.
Corneal ulcers (serious risk of vision loss).
Progressive vision impairment.
Amblyopia (lazy eye).
Poor quality of life due to constant tearing and discomfort.

Treatment of entropion in children with medications

Medical treatment does not fix the underlying cause (mechanical eyelid issue) but can reduce symptoms and protect the eye until surgery if needed:

Lubricating drops (artificial tears): reduce friction and dryness, provide comfort.
Lubricating eye ointments (especially at night): coat and protect the cornea during sleep.
Antibiotic eye drops: for bacterial infections or heavy discharge.
Anti-inflammatory eye drops: for severe irritation, only under a doctor’s supervision.

Types of Surgeries for Entropion in Children

1. Skin or Muscle Resection
A small strip of skin or muscle causing the entropion is removed.
✅ Goal: Tighten the eyelid and return it to its normal position.
➡️ One of the simplest and most common procedures in children.

2. Everting Sutures
Fine stitches are placed to prevent the eyelid from turning inward.
✅ A temporary solution suitable for younger children until they are old enough for a definitive surgery.

3. Tarsal Strip Surgery
Used in cases of weak or loose eyelid cartilage.
✅ The cartilage is tightened or reinforced to keep the eyelid straight.

4. Canthal Tightening (Rebuilding the Ligaments)
Addresses weakness or laxity in the inner or outer eyelid ligaments.
✅ Restores the eyelid’s natural balance.

5. Reconstructive or Cosmetic Surgery
Used in severe cases or those caused by trauma or burns.
✅ May involve skin grafting or reshaping eyelid tissues.

6. Laser Surgery (Rare in Children)
Reshaping the eyelid skin or tissue using laser instead of traditional tools.
➡️ Mostly performed in adults, not commonly used for children.

Benefits of Surgery in Children

High success rate.
Prevents corneal ulcers or vision problems.
Improves eyelid appearance and protects vision long-term.

Tips to Prevent Entropion in Children

✔️ Early checkups: Regular visits to a pediatric ophthalmologist.
✔️ Quick treatment of infections: Address any redness, discharge, or swelling immediately.
✔️ Avoid eye rubbing: Teach the child not to rub their eyes strongly.
✔️ Prevent injuries: Keep sharp toys and chemicals away.
✔️ Use lubricating drops: Only as prescribed by the doctor.
✔️ Healthy nutrition: Foods rich in vitamins A and C support eye health.
✔️ Protect from sun and wind: With suitable sunglasses for children.
✔️ Watch for changes: See a doctor if the eyelid turns inward or if tearing persists.

Helpful Exercises for Entropion in Children

1. Strong Eye Opening and Closing

Child opens eyes as wide as possible, then closes them tightly.
Repeat 10 times, 3 times daily.
➡️ Strengthens eyelid muscles.

2. Gentle Eyelid Massage

Circular massage around the eyelid.
Sometimes with light outward pressure to reduce inward turning.
⚠️ Must be done carefully under medical supervision.

3. Eyelid Taping

A thin medical tape pulls the eyelid outward.
Changed every few hours.
➡️ Temporary solution to prevent lashes from rubbing the cornea.

4. Up and Down Eye Movements

Child looks up as far as possible, then down.
Repeat 10 times daily.
➡️ Activates muscles related to eyelid movement.

5. Squinting Exercises

Child closes the eyes halfway and holds for 5 seconds, then opens.
Repeat 10 times.
➡️ Strengthens the front eyelid muscles.

⚠️ Important Notes:

Exercises, massage, and taping are only temporary solutions.
In most cases, the main treatment is a simple surgery.
All exercises must be done under the supervision of a pediatric ophthalmologist to protect the cornea.