There are three types of lid entropion: 1. Congenital lid entropion: This is most often seen in infants and young children and is caused by an inner canthus, overdevelopment of the orbicularis muscle at the lid margin, or underdevelopment of the lid plate. 2. Spastic lid entropion: This occurs mostly in the lower lid and is commonly seen in older adults due to the beginning of lower lid contraction muscle weakness, loss of contraction of the orbital septum and lower lid skin, and lack of adequate support behind the eyelid due to reduced orbital fat in older adults. If inflammatory stimulation causes reflex spasm of the lid orbicularis muscle, useful especially near the lid margin, causing the lid margin to roll inward to form an entropion, it is called polar spastic entropion. 3. Scarring lid entropion: This can occur in both the upper and lower lids. It is caused by scarring of the lid conjunctiva and lid plate and is common in those with trachoma. Clinical manifestations Patients have photophobia, tearing, stinging, and eyelid spasms, and the lids are seen to curl left and right, especially at the lid margins toward the eyeball, and the inverted eyelashes rub the cornea, and the corneal epithelium may be detached. Diffuse fluorescein staining, if secondary to infection, can develop into corneal ulcers. If left untreated for a long time, the cornea has neovascularization and loses its transparency, causing vision loss in the lid entropion. Treatment 1. Congenital lid entropion disappears on its own with age and nasal development, so there is no need to rush surgical treatment. If the child’s eyelashes remain entropion and severely irritate the cornea, surgical treatment may be considered. A lid skin threading procedure is performed in the dome of the eyelid to correct the entropion by pulling the lid margin outward with the force of the suture pull. 2. Age-related lid entropion can be treated by surgically removing the excess loose skin and cutting off some of the orbicularis oculi muscle fibers. 3. Scarring lid entropion must be treated surgically Either lid wedge resection or lid dissection can be used.