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Eyelid Malposition—Entropion & Ectropion
Entropion
Entropion is a condition in which the eyelid is rolled inward toward the eye. It can occur as a result of advancing age and weakening of certain eyelid muscles. Entropion may also occur as a result of trauma, scarring, or previous surgeries. Entropion may also occur in children.
A turned in eyelid rubs against the eye, making it red, irritated, painful, and sensitive to light and wind. If it is not treated the condition can lead to excessive tearing, mucous discharge and scratching or scarring of the cornea. A chronically turned in eyelid can result in acute sensitivity to light and may lead to eye infections, corneal abrasions, or corneal ulcers. If entropion exists, it is important to surgically repair the condition before permanent damage to the eye occurs.
Surgical Repairs
There are a number of surgical techniques for successfully treating entropion, depending on the cause and presenting anatomic problem. The most common surgical treatment involves tightening of the eyelid attachment to the eye socket, while reinforcing the muscle attachments on the inside of the eyelid to restore the lid to its normal position. The surgery to repair entropion is usually performed as an outpatient procedure under local anesthesia or with IV sedation. Patients recovery quickly using an antibiotic ointment for about one week after surgery. Most patients experience immediate resolution of the problem following surgery.
In certain situations, a non-incisional entropion repair, using only sutures, may be performed as an in-office procedure under local anesthesia. This procedure, sometimes referred to as the “Quickert” procedure requires several strategically placed sutures which externally rotate the eyelid. This procedure is an excellent treatment for patients who are not suitable for surgery, or until more definitive surgery can be performed.
Ectropion
Ectropion is an eyelid malposition indicating the lower eyelid is “rolled out” away from the eye, or is sagging away from the eye and the wet, inner surface of the eye (conjunctiva) may be exposed and visible. Normally, the upper and lower eyelids oppose each other, lubricating and protecting the eye. If the edge of one eyelid turns outward, the two eyelids cannot meet properly and tears are not spread evenly over the eye, and the sagging lower eyelid may leave the eye exposed and dry. If the ectropion is not treated, the condition can lead to chronic tearing, eye irritation, redness, pain, a gritty feeling, crusting of the eyelid, mucous discharge, and breakdown of the cornea due to exposure.
Frequently Asked Questions
Who Should Perform The Entropion or Ectropion Surgery?
When choosing a surgeon to perform entropion surgery or ectropion repair, look for a cosmetic and reconstructive facial surgeon who specializes in the eyelids, orbit, and tear drain system. Dr. Amadi’s membership in the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) indicates he is not only a board-certified ophthalmologist who knows the anatomy and structure of the eyelids and orbit, but also has had extensive training in ophthalmic plastic reconstructive and cosmetic surgery.
What Causes Ectropion?
Generally the condition is the result of tissue laxity associated with aging, although it may also occur as a result of facial nerve paralysis (due to Bell’s palsy,stroke or other nurologic conditions), trauma, scarring, previous surgeries or skin cancer.
Can Ectropion Be Repaired?
Yes, ectropion can be repaired surgically. Most patients experience immediate resolution after surgery with improvement of the symptoms, while experiencing minimal post-operative discomfort. Initially the eyelid may feel tight and slightly unnatural. But after your eyelid heals, your eye will feel comfortable and be protected from corneal scarring, infection, and loss of vision.