Eyelid Malpositions: Entropion and Ectropion

Have you ever wondered what happens to the eye when the eyelid is positioned incorrectly? Abnormal positioning of the eyelid is known as eyelid malposition and can result in two separate disorders of the eyelid. When the eyelid turns inward it is known as “entropion.” Conversely, “ectropion” is the term for an eyelid that turns outward. 

Although entropion and ectropion are two different disorders, they have some overlapping symptoms. Shared symptoms of entropion and ectropion are excessive tearing, mucus discharge, ocular surface irritation and itching, impaired vision, redness, and sensitivity to light and wind. With ectropion, you may also notice sagging skin around the eye. 

While in many cases entropion and ectropion require surgery, there are also treatments that can be tried before surgery is declared necessary. With ectropion, artificial tears and lubricating ointments can be used to provide temporary relief, but surgery would be recommended if symptoms persist. With entropion, artificial tears and lubricating ointments can also be used, as well as, tape or dissolving sutures to reposition the eyelid and temporarily protect the eye. Botox can be a temporary solution as well. However, if entropion does not resolve quickly, then a surgical plan would be recommended. 

Surgery for both entropion and ectropion are outpatient procedures, meaning that the patient is able to return home shortly after surgery and recover in the comfort of their own home. The overall procedure takes approximately 30 minutes and the patient is given local anesthesia and possibly sedation before the surgery. The surgical technique for both entropion and ectropion differ based on the cause of the eyelid malposition, but typically cause minimal pain. Following the surgery, swelling and bruising can last up to three weeks. For ectropion, it is common for the eyelid to appear over tightened for the first couple of weeks after surgery, but the “overcorrected” look, should go away during the healing process.

Following surgery, an eye ointment is prescribed to prevent infection and aid in the eyelid’s recovery process. Additional eye patches or bandages are usually not required. Patients who have undergone the procedure shouldn’t get their eyelids wet, partake in strenuous exercises, bend over, wear make-up, or drink alcohol. 

If you have entropion or ectropion, you might be wondering, why did this happen to me? There are a variety of reasons for your eyelid malposition, such as aging, prior eyelid surgery, excess tissue on the eyelids, or damage to the muscle that controls the opening and closing of the eyelids. An involutional entropion and ectropion are when the tendons of the eyelids become looser with age, causing irritated, watery, and red eyes. If someone has scars on their eyelid tissues, they could have a cicatricial entropion or ectropion, causing similar symptoms to an involutional entropion or ectropion. Issues that cause scarring of the tissues such as prior surgery, trauma, burns, chemical injuries, infections, certain types of medications, some inflammatory or autoimmune diseases are likely the cause of a cicatricial entropion or ectropion. In cases where the facial nerve, which controls the muscle that closes the eye, is damaged, a paralytic ectropion or a spastic entropion can result. A paralytic ectropion is when the lower eyelid loses muscle tone and can drop and turn out, while a spastic entropion is when there is a spasm in the muscle that closes the eye which can causes the lower eyelid to rotate in.

If you suspect you have an entropion or ectropion and want a consultation or if you have one and need someone to do the surgery come to our office today. Dr. Carniciu and Dr. Chon are experts on treating eyelid malpositions and can help you finally find relief!

For more information check out the references below:

Ectropion repair. (n.d.). Retrieved August 15, 2022, from https://oceyelids.com/services/reconstructive/ectropion-repair/

Entropion and ectropion repair. (n.d.). Retrieved August 15, 2022, from

https://www.healthdirect.gov.au/surgery/entropion-and-ectropion-repair#:~:text=relevant%20health%20professional.-,What%20is%20entropion%20and%20ectropion%3F,does%20not%20touch%20your%20eye

Entropion & ectropion. (n.d.). Retrieved August 15, 2022, from

https://www.ocli.net/services/oculoplastics/entropion-ectropion/

Entropion repair. (n.d.). Retrieved August 15, 2022, from https://oceyelids.com/services/reconstructive/entropion-repair/

Entropion Surgery. (n.d.). Retrieved August 15, 2022, from

https://www.milaneyecenter.com/oculoplastics-center/corrective-reconstructive-procedures/entropion-surgery/

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