This photo demonstrates entropion, an inward rotation of the eyelid margin with resulting misdirection of the eyelashes. This patient was diagnosed with involutional entropion, which is caused by horizontal eyelid laxity, disinsertion of the lower eyelid retractors, and an over-riding orbicularis oculi muscle. In the photo, note the inward rotation of the lower eyelid margin with misdirected eyelashes abrading the cornea centrally and causing conjunctival injection. Also, note the "mounding" of the orbicularis oculi muscle indicative of an over-riding muscle.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.