Involutional entropion is a common condition among the elderly in which turning of the lower eyelid causes, irritation, tearing, redness and photophobia. Rarely untreated entropion may result in a corneal ulcer.The main factor giving rise to involutional entropion is the progressive degeneration of the elastic and fibrous tissues within the lid occurring with increased age.This degeneration causes an imbalance between the usual forces acting on the lower eyelid and the resulting eyelid laxity both;•Vertical (lower eyelid retractors, and orbital septum) and•Horizontal (tarsal plate and orbicularis) allows the orbicularis to override. Surgery remains the mainstay for permanent treatment.It is generally accepted that, for the best result, surgery should address both horizontal and vertical laxity.