Eyelid Malposition (Ectropion, Entropion, Retraction)
Ectropion is a malposition of the eyelid where the margin and eyelashes are turned outwards. The skin, muscles, and tendons of the lower eyelid can sag or droop with aging. As the tendons of the lower lid sag, the lower lid can evert and turn inside out. This can lead to eye watering, mucous discharge, crusting of the eyelashes, and dry eye. When ectropion is corrected and the eyelid repositioned, tearing, mucous discharge, patient comfort, and aesthetics typically improve.
Entropion is an internal rotation or malposition of the eyelid. As the tendons of the lower eyelid detach with age, the lower eyelid can invert and turn inward with the lashes rubbing the surface of the eye. Protruding fat in the lower eyelid can also contribute to this problem. Chronic scarring and infections can also cause the eyelid margin to rotate internally which can irritate the eye, thereby irritating the eye. Over time, this can lead to tearing, mucous discharge, crusting of the eyelashes, and scratching of the cornea. Surgical correction of entropion typically improves chronic irritation, foreign body sensation, tearing, and mucous discharge.
A retracted eyelid is abnormally positioned too high (upper eyelid) or too low (lower eyelid). There are many causes of eyelid retraction including thyroid eye disease, heredity, skin cancer, scarring, trauma, or prior surgery. As there are several different surgical techniques utilized for correction of eyelid retraction, it is important to use a physician who specializes in this surgery.