My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Gregg Gayre, MD
Ophthalmology: Oculoplastic
Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.
My Offices
- San Rafael Downtown Medical Offices
- Appt/Advice: 415-444-2990
Quick Links
- Eyelid Surgery
- Orbital Surgery
- Surgery to Remove An Eye
- Tearing
- Examples of supplements used Pre and Post Op
- Oculoplastic Post Operative Instructions
- Blood Thinners to avoid prior to surgery
- Wellness Coaching
- Eye Videos
- Prepare for Your Procedure - Emmi
- Laser Vision Correction
- Dry Eye Handout
- Cataract Class
- Using the Amsler Grid
- Blepharoplasty
- Blepharoptosis
- Blowout Fracture
- Brow Ptosis
- Ectropion
- Entropion
- Nasolacrimal Duct Obstruction
- Strabismus and Amblyopia
- Subconjunctival Hemorrhage
- Thyroid Eye Disease
- American Academy of Ophthalmology
- Cataract Surgery
- National Eye Institute
- Vision Essentials
General References
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Entropion
Introduction
Entropion is the medical term used to describe a condition where the eyelid and eyelashes turn in or roll inward towards the eye. This causes the eyelid and its lashes to constantly rub against the sensitive surface of the eye known as the cornea and conjunctiva.
Most cases of an in-turned eyelid are due to relaxation of the tissues of the eyelid as a result of aging. Thus, it is most often seen in elderly people who develop stretching of the structures supporting the lower eyelid that permits the lower eyelid to turn inward. This form of entropion is referred to as involutional entropion. Some cases result from scarring of the inner surface of the eyelid caused by chemical and thermal burns, inflammatory diseases such as ocular pemphigoid, or allergic reactions. This form of entropion is known as cicatricial entropion. Rarely an in-turned eyelid can be present at birth if the eyelids do not form properly. This type of entropion is referred to as congenital entropion. In some cases excess upper eyelid skin can overhang the eyelashes of the upper lid forcing them in contact with the cornea. This condition is referred to as mechanical entropion. In patients of asian descent an extra roll of muscle in the lower eyelid skin is quite common, particularly in youth and can induce in-turned eyelashes. This condition is known as epiblepharon.
Symptoms
An in-turned eyelid allows eyelashes to rub against the sensitive surface of the eye. This rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge, a feeling that something is in the eye, and impaired vision.
Screening and Diagnosis
Your doctor will perform a complete eye exam prior to recommending treatment. The exact cause of the eyelid mal-position will be determined. You doctor will determine whether any muscles or tendons are weak or if this is excess scarring on the undersurface of your eyelid.
Treatment
An in-turned eyelid should be repaired surgically before the rubbing damages the cornea by causing infection and scarring. Prior to surgery, taping the lower lid down and using lubricating drops and ointment can protect the eye. Botox may be injected into the lower eyelid to temporarily relax the muscles and prevent the eyelid from flipping inward. In some cases, sutures can be placed through the lower eyelid until more definitive surgery can be performed.
The usual surgical management for an in-turned eyelid involves tightening of the lower eyelid and its attachments to restore some of its elasticity and to reposition it normally. There are a number of surgical techniques for successfully managing an in-turned eyelid and the best technique for you will be selected based on your examination, the type of entropion, your associated medical conditions, ease of recovery and risks of the procedure. In instances of cicatricial entropion scar excision and tissue grafts may be necessary.
Entropion repair is usually performed as an outpatient in your doctor's office or an ambulatory surgical center. Discomfort is usually minimal after surgery. Your surgeon may advise not taking aspirin products and blood thinners before and after surgery, as they may increase bruising. Following surgery your lids will feel a bit tight due to the swelling and bruising that normally accompanies surgery, and your eyes may tear and feel dry initially. You should use cold packs after surgery to help reduce swelling and limit yourself to quiet activities for the first few days to help decrease bleeding or bruising. You can plan more vigorous activity about two weeks after your surgery. Most patients return to their work or social schedule in one to two weeks and the majority of healing is complete at about six weeks.
In general, complications of entropion repair are rare and minor when performed by a surgeon trained in the surgical techniques. However, it is possible for the patient to experience problems including infection, prominent scarring or recurrence of the entropion necessitating further surgery.
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.