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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
RapidMLAMSRAGP

Entropion, ectropion and trichiasis

Essential points for quick revision.

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Protect an injured or exposed cornea

Lash abrasion and incomplete eyelid closure can progress to epithelial breakdown, infection and loss of vision.

Action: Arrange urgent ophthalmic assessment for pain, photophobia, reduced vision, a corneal defect or infiltrate, or inadequate protection despite temporary measures.

Synopsis

Identify whether the eyelid or individual lashes are malpositioned, assess corneal risk and provide effective temporary protection while arranging definitive treatment.

  • Entropion turns the lid margin inward; trichiasis describes lashes directed towards the eye.
  • Ectropion turns the margin outward and can cause both exposure and poor tear drainage.
  • A watery eye may still have a dry and damaged surface.

Key red flags

A new fall in acuity or marked light sensitivity alongside lid malposition.

Investigation priorities

01
Acuity and ocular surface examinationFirst step

Measure functional impact and identify abrasion, infection or exposure damage.

Management branches

Cornea at immediate riskEscalate and protect the surface

Pain, visual deterioration or epithelial damage accompanies the eyelid abnormality.

  1. Assess acuity and corneal findings while arranging urgent ophthalmic assessment.
  2. Provide suitable lubrication and a safe protection method without delaying examination of possible infection.
Comfortable protected surfaceBridge to routine specialist care

Chronic lid malposition causes symptoms without current sight-threatening features.

Key medicines

Carmellose sodium 0.5% single-dose eye dropsFor the cited Celluvisc product, instil one or two drops into the affected eye four times daily or as needed.
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Sources and review status6 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom