With malposition of the lower lid of the eye, the lid margin may be turned inward toward the eye (eyelid entropion), or outward away from the eye (eyelid ectropion). In both cases, there may be significant symptoms involving impaired vision, irritation, undesirable appearance, or discomfort.
Analogy: Imagine the lower lid of the eye as a tennis net. If the tennis net gets loose, it can flop in or out. Similarly, when the lower eye fold tendon gets loose over time, due to aging (or other causes), the eyelid can turn in (entropion) or out (ectropion).
Eyelid Entropion (eyelid turns in)
Entropion means the eye fold is turned inward, with the lashes rubbing against the eyeball. It most commonly occurs in the lower eyelids, but can also happen to the upper eyelids. There are various causes of eye fold entropion, including age, trauma, infections, congenital, and previous eye surgeries.
When the eyelid is turned in, the lashes rub against the eyeball, causing significant irritation, redness, and tearing. It may even cause scratching or scarring of the cornea.
If eyelid entropion exists, it is important to have a surgeon repair the condition before permanent damage to the eye occurs.
How is Eyelid Entropion Repair Performed?
Eyelid entropion should be treated as the turned in lashes can cause damage to the cornea, with vision loss, in addition to eye irritation, redness, and tearing.
There are nonsurgical and surgical treatment options available for treating entropion. Botulinum toxin (Botox) injection and eye fold taping can temporary relieve entropion. A permanent solution is obtained by lower eyelid surgery, by everting and tightening the eyelid. At times, if caused by scarring, grafts may be needed.
Eyelid entropion surgery is usually performed under local anesthesia, with or without sedation, on an outpatient basis. As with most eyelid procedures, the recovery is quick and painless except for a “black eye” for a few days. Most patients experience immediate resolution of the problem following surgery.
The Quickert procedure is an excellent treatment for patients who are not suitable for surgery, or until more definitive surgery can be performed. The Quickert procedure requires 2-3 strategically placed sutures that will evert the eyelid. The sutures will keep the lashes from rubbing against the eye.
Eyelid Ectropion (eyelid turns out)
Ectropion means the eye fold is turned outwards, away from the eyeball. As with entropion, it occurs in the lower eyelids much more commonly than in the upper eyelids. The droopy lower eyelid causes the eyeball to be more exposed to air with eye irritation, redness, and tearing. If severe enough, the cornea can become affected with visual loss.
The most common cause of eyelid ectropion is age related relaxation of the eyelids. Other causes include scarring, sunlight, previous surgery, trauma, and facial palsy.
Normally, the upper and lower eyelids close completely, protecting the eyeball from air and dryness. When the lid of the eye is turned outwards, the eyeball becomes exposed to more air, which causes eye irritation, redness, discharge and reflex tearing. The inner side of the eye fold can also become exposed to air, causing chronic redness and redness. This can also interfere with the tear drainage system of the eye.
How is Eyelid Ectropion Repair Performed ?
The treatment for eyelid ectropion is typically reconstructive surgery. The type of surgery needed can depend on the type of ectropion (involutional or age-related, cicatricial or scarring, paralytic, congenital).
The classical eyelid ectropion repair surgical technique is the tarsal strip method and canthoplasty. Dr. Taban also uses an alternative, minimally invasive approach to tight the lower eyelid, which provides better lid of the eye contour with hidden scars. To learn more about this technique, read Dr. Taban’s article: Aesthetic Lateral Canthoplasty.
Cicatricial ectropion requires addition of skin to the lower eye fold (skin graft). Dr. Taban avoids the use of skin graft and uses a skin flap from the upper eye fold (“switch flap” technique) to provide a better tissue and color match, so that the added skin will best match surrounding skin and blend in.
Surgery is usually performed under local anesthesia, with or without sedation, on an outpatient basis. As with most eye fold procedures, the recovery is quick and painless, with about 7-10 days of swelling, bruising.
During your consultation with Dr. Taban in Beverly Hills/Los Angeles or Santa Barbara, he will evaluate your eyelids and face and discuss the cause of your eyelid entropion or eyelid ectropion and its eyelid position correction treatment through surgery. As with all reconstructive oculoplastic procedures, the goal of surgery is to restore the eyelids to a more natural position. As an oculoplastic surgery expert, Dr. Taban uses minimally invasive techniques for quicker recovery with eyelid entropion or eyelid ectropion surgery.
Learn more about lid of the eye ectropion and entropion procedures from Mayoclinic.
Contact a Beverly Hills Oculoplastic Surgeon
An uncomfortable malposition of the eyelid can interfere with daily life and threaten one’s eyesight. Fortunately, the specially designed treatments for this condition can be performed painlessly and provide flawless results. Most people would not be able to tell that a patient has undergone the procedure just by looking. The results are that seamless.
Without treatment, entropion can be incredibly uncomfortable and may damage eyesight. Don’t wait to get the relief and results you need and deserve.
Next, please read about lower eyelid surgery.