When an Eyelid Turns the Wrong Way

Eyelid Malposition – Entropion & Ectropion MIWhen your eyelid flips the wrong way — maybe it turns inward, or maybe outward — this can lead to pain, irritation, and problems with tear drainage. These eye conditions, entropion, and ectropion, can be corrected with surgery by the team at Consultants in Ophthalmic and Facial Plastic Surgery.

What is entropion?

When the eyelid turns inward, usually on the lower eyelid, this is known as entropion. The lid may be turned inward at all times, or only when the eyelids are closed tightly. Either way, when the lid turns inward, the skin and eyelashes can rub on the cornea, which can be very painful. Entropion can also make the eye sensitive to light and the wind.

What causes of entropion?

In most cases, entropion is the result of the muscles weakening around the eye, a result of natural aging. A spasm or simple relaxing of the muscles near the eye can cause the lower eyelid to turn inward. Other causes can be the injury to the lid, a congenital defect, skin infections, or certain inflammations. People who have had facial surgery, particularly in the mid-face, are more prone to entropion.

Fixing entropion

There are non-surgical options to remedy entropion such as lubricating eyedrops, Botox injections, even strategically placed stitches. But these are temporary fixes; usually, entropion needs to be corrected with outpatient surgery by our team. In this minor surgery, the eyelid in question or both eyelids are repositioned.

The area is numbed with local anesthetic, sometimes with light sedation depending on the patient. If the cause is muscle weakness, our surgeons remove a small section of the eyelid to tighten the muscles in the area. If entropion is due to scars from injury or a prior surgery, a skin graft may be necessary to reposition the eyelid.

What is ectropion?

The reverse of entropion, ectropion is a “turning out” of the eyelid. Again, this typically occurs on the lower eyelid. The sagging skin of the inner eyelid is exposed, either in one part of the lid or across the entire lid. Compared to entropion, ectropion causes more disruption with the eye. With ectropion tears are prevented from draining correctly out of the eye, leading to chronic tearing, redness, pain, a gritty feeling, crusting of the eyelid, mucous discharge, even a breakdown of the cornea.

Causes of ectropion

Again, most cases of ectropion usually stem from aging muscles. But ectropion can also result from nerve damage, sun damage, tumors, burns, or eyelid surgery (blepharoplasty) where too much skin was removed. The condition can also be congenital.

Fixing ectropion

Artificial tears can provide temporary relief from the dryness that accompanies ectropion, but surgery is usually necessary to fix the condition. The surgical options/methods are similar to those for entropion. If muscle weakness is the cause, a small portion of the eyelid may be removed, and the muscles tightened. If too much skin was removed during blepharoplasty, a skin graft would be necessary.

Correcting both entropion and ectropion is not a difficult surgical procedure, but it demands a high level of expertise. Trust the extensive experience and training of the team at Consultants in Ophthalmic and Facial Plastic Surgery. Call us at 248-357-5100 for a consultation.

Posted in: Eyelid Malposition

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