Eyelids can sometimes turn in the wrong direction, causing the eyelid malpositions called ectropion and entropion. Whether the eyelid “turns in” (entropion) or“turns out” (ectropion), the patients may experience discomfort and further medical complications. At the Dallas and Plano offices of Oculoplastic Associates of Texas, eyelid malposition surgery is offered to repair ectropion and entropion conditions.
Ectropion is a “turning out” of the eyelid that causes redness, irritation, tearing and an increased likelihood of infection of the eye. Common causes of ectropion include aging, laxity of the eyelids, sun damage, tumors, burns and the removal of too much skin during blepharoplasty. Over time, if the condition is not treated, the cornea may become damaged due to abrasions, ulcers, or infections, resulting in some loss of vision. Artificial tears can help provide temporary relief from dryness. Ectropion can be corrected with a simple procedure under local anesthesia (often with sedation) in which the eyelid is tightened. If the ectropion is due to scarring or other changes, a skin graft may be required to bring the eyelid to the natural position.
Entropion is a “turning in” of the eyelid. The lid and lashes rub painfully against the cornea, which is the very sensitive surface of the eye. Entropion usually occurs as a result of aging, but other causes can include injury, congenital defects, and various inflammatory conditions. A spasm can cause the lid to turn inward as well. Entropion can often be corrected with a brief surgical procedure in the office or under anesthesia. In some cases, surgery may involve methods to realign and tighten the lid to correct eyelid laxity. Your doctor will also assess for any scarring on the inside of the eyelid that may be causing the eyelid to turn in, such as a condition known as ocular cicatricial pemphigoid.
Ectropion and entropion disorders generally need to be corrected through a brief surgical procedure in which the eyelids are repositioned. The area is numbed with a local anesthetic and sometimes light sedation is provided as well. For ectropion or entropion due to muscle weakness, the surgery may involve the removal of a small section of eyelid to tighten the muscles in the area. When it is caused by scars or prior surgery, the procedure typically relies on a skin graft to allow a repositioning of the eyelid. Most eyelid repair surgeries take about 30 minutes to complete.
Patients should expect to have temporary swelling, redness, and mild pain around their eyes for the first 2 weeks after the surgery. The doctor advises patients to rest as much as possible and many patients take 5-7 days off from work. Patients should schedule a follow up appointment for 1-2 weeks after the surgery so the doctor can evaluate the results.
Lubricating eye drops may be used to lessen certain symptoms such as dry eyes. Temporary relief can also sometimes be achieved with skin tape to hold the eyelid in place or strategically placed stitches.
Entropion eyelids usually occur as a result of aging, but other causes can include injury, congenital defect, and various inflammatory conditions Ectropion eyelids can be caused by aging, facial nerve paralysis, a congenital birth defect, or scar tissue from previous trauma.
The doctor will customize each eyelid surgery to best suit the needs of the patient, including performing surgery on only one eyelid if needed. If both eyelids need surgery, but one needs more correction than the other, the doctor will adjust their technique to ensure the eyes and eyelids will be as even and symmetrical as possible.