Eyelid Malposition

Eyelid malposition, which includes ectropion and entropion, is a common condition in which the eyelid turns either outward or inward, causing discomfort, dryness, and even damage to the surface of the eye.

Ectropion is the outward turning of the eyelid away from the eye, usually occurring in the lower eyelid. This condition can cause redness and dryness due to exposure, leading to discomfort and watering of the eye.

Entropion is when the eyelid turns inward, causing the lashes to rub against the surface of the eye.

The primary cause of ectropion is age-related changes in the eyelid, which result in tissue laxity or looseness. However, trauma, previous surgery, facial nerve (Bell’s) palsy, or sun damage can also cause ectropion, or make it worse.

Entropion may be caused or made worse by muscle spasm, scarring of the eye lining, or trauma. This condition often leads to significant discomfort and can cause damage to the surface of the eye. While it most commonly occurs in the lower eyelid, it can also involve the upper eyelid.

Both ectropion and entropion can be successfully treated with surgery. In most cases, treatment for entropion is recommended, while ectropion may not require treatment if symptoms are mild. Lid taping may be used to provide symptomatic relief of entropion while surgery is planned. Dr Parker performs both procedures as a day surgery in his office under local anaesthesia.

Read more about in-office surgery with Dr Parker  

The surgical approach for ectropion and entropion varies depending on the underlying cause. In most cases, the eyelid laxity will need to be corrected by tightening the eyelid. There are several techniques used to achieve this, and Dr Parker will discuss your options.

If the condition is present in both eyes, it is often (but not always) possible to correct both eyes at the same time.

If ectropion is caused by skin shortage or scarring, a skin graft may be necessary to relieve the downward and outward pulling. In these cases, the eye may need to be padded shut for several days after the operation.

Because entropion is usually very painful and can damage the eye, Dr Parker may recommend temporary sutures to quickly correct entropion while waiting for a more definitive operation.

The surgery typically requires a cut to be made in the skin underneath the eyelashes along the length of the eyelid, in addition to lid tightening. This cut will cause a scar in the skin, but in most circumstances, it will heal to be very level.

As with all eye surgeries, there are risks and potential complications associated with surgery for eyelid malposition.

Bruising and swelling may occur but typically settle within one to two weeks. Infection and bleeding are uncommon but are potential risks associated with all skin-based surgeries.

While damage to the eye or loss of sight are theoretical risks, they are considered extremely rare.