Entropion & Ectropion

Entropion is a condition in which the lower eyelid turns inwards. The most common form of entropion develops from a weakening and stretching of the tendons that are connected to the orbital rim of bone. As a result, the eyelid rotates inwards against the eye. Pain from lashes and skin rubbing against the cornea can be severe. Entropion may also affect vision secondary to the corneal involvement. Surgical correction involves the rotation of the lid margin back to its normal position by tightening the tendons and the tendon-like sheath.

Another form of entropion is associated with scarring, usually from trauma or infection, on the inner surface of the tissue in the eyelid and/or within the internal structure of the eyelid. While uncommon in the United States, this variant of entropion is a leading cause of blindness in underdeveloped countries.

Patients with ectropion have a sagging lower eyelid that leaves the eye exposed and dry. The supporting structure of the lower eyelid may be compared to a hammock, with a cartilage-like central stiffener piece that is attached to the socket bone on either side of the eye by two tendons. If the tendons become stretched due to wear-and-tear or from trauma or even other eyelid surgery, the lid may lose its normal adherence to the eye surface and sag outwards.

In the presence of ectropion, wind and dust may dry and irritate the delicate tissue lining the inner tissue of the exposed eyelid. In addition, the draining mechanism of the tears can no longer function normally, resulting in the stream of tears down one’s face.

Eventually, an eye with ectropion may develop scarring from the dryness.

Ectropion eyelid surgery is designed to tighten the stretched tendons and shorten the stretched lid. If the tendons have become too shredded, an entirely new means of support may be created by borrowing tissue from nearby healthy tissues.