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Eyelid Ectropion & Eyelid Entropion

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.

Eyelid Entropion Symptoms

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 temporarily 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.

What is Eyelid Entropion 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.

Before & After Photos

*See disclaimer below
Before (left) and after (right) lower eyelid entropion surgery.
Before (left) and 2 months after (right photo) of right lower eye fold entropion surgery (eyelid turns in).
Before (left) and 3-months after (right) left lower eyelid entropion surgery.
Before (left) and 2 months after (right photo) of LEFT lower eyelid congenital Epiblepharon surgery (eyelid turns in).

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.

Eyelid Ectropion Symptoms

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.

60+ year old woman underwent lower eyelid ectropion/retraction repair with skin graft after botched aggressive lower blepharoplasty.
60+ year old woman underwent lower eyelid ectropion/retraction repair with skin graft after botched aggressive lower blepharoplasty.

Read an Article by Los Angeles’ Dr. Taban about his Lateral Canthoplasty techniques.

Lateral Canthoplasty Before Image

Before & After Photos

*See disclaimer below
Before (left) and 4 months after (right) lower eye fold ectropion surgery (with switch flap technique, eyelid skin graft).
Before (left) After (right) 70 year old male, who underwent right lower eyelid ectropion surgery with skin graft.
Before (left) and after (right) 1 month following eyelid reconstruction to correct previous lower blepharoplasty (by another surgeon) with resultant lower eyelid retraction and ectropion with sclera show and canthoplasty (by another surgeon) without benefit.
Before (left) and 3 months after (right) lower eyelid ectropion surgery.

Contact Beverly Hills Oculoplastic Surgeon Dr. Taban

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. Contact Dr. Taban today for a consultation.

Next, please read about eyelid retraction surgery.

*Disclaimer: Results vary from patient to patient. Results are not guaranteed.
Overall…… Excellent! I had a procedure …called “Ectropion Surgery” … I highly recommend My surgery was such success!……Thank You Again Dr. Taban
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Sincerely your new patient Mr.V Maye

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