Ectropion & Entropion
Ectropion is an eyelid position problem characterized by the eyelid turning outward. The lower eyelid has several important functions. It maintains contact with the surface of the eye and protects its surface as well as holding a “lake of tears” in place for the upper lid to sweep tears across the eye during a blink. The lower eyelid also serves to direct the tears toward the tear drainage system. The normal position of the lower eyelid is snugly opposed to the inferior edge of the cornea but with ectropion it is turned outward and loose. There are several reasons for the lower eyelid to maintain an abnormal position. The most common is simply the effects of aging and gravity. Over time, the lower eyelid can stretch and become lax, and no longer sit in the proper position. It may roll outward or droop downward, and the white part of the eye may show beneath the cornea. Symptoms of ectropion can include irritation associated with drying out of the corneal surface as the tear film is no longer in the proper location and even excessive tearing. The tearing may be caused as the eye tries to protect the corneal surface and as the tears are not being directed toward the tear drainage system. If the lower eyelid is turned outward as with ectropion, the eyelid margin may become thickened and irritated as the mucosal surface dries out. This can lead to further irritation and scarring of the tear drainage system. As explained above, the most common cause of ectropion is the effect of aging and gravity. Fortunately, ectropion can most often be corrected with an outpatient eye surgery procedure by tightening the eyelid with a simple surgical technique
Other causes of ectropion include certain eyelid skin conditions, scarring of the skin associated with skin cancers and previous surgeries. The correction of these types of ectropion eyelid problems may require specialized techniques including skin grafting. Another cause of ectropion may occur if the lower eyelid may sags or maintains an abnormal position when the nerve input to the muscle is damaged from strokes, facial nerve palsies or Bell’s palsy. Correction in these situations may require other special techniques.
Entropion is an eyelid position problem characterized by the eyelid turning inward. When this occurs, the eyelashes and the skin of the eyelid can rub against the surface of the eye and cornea causing considerable irritation and even serious damage. The most common cause is simply a laxity of the lower eyelid as the aging process and effects of gravity occur. Specialized muscles may loosen or weaken, allowing the eyelid to maintain an abnormal position. Most of the time, correction of this problem requires a simple same-day surgical technique. Other causes of entropion include certain conditions which cause scarring of the conjunctiva, chronic use of certain topical medications, some chemotherapy, burns and injury.