Entropion and Ectropion
Eyelid Turning Inward (Entropion)
Entropion is the medical term used to describe rolling inward of the lower eyelid and eyelashes towards the eye. The mal-position of the eyelid causes the skin of the eyelid and the eyelashes to rub against the cornea (the front part of the eye) and conjunctiva (the mucous membrane that protects the eye). This rubbing can lead to irritation, tearing, damage to ocular surface, infection and loss of vision.
Most cases of entropion are due to relaxation of the tissues of the eyelid as a result of aging. Some cases result from scarring of the inner surface of the eyelid caused by chemical and thermal burns, inflammatory diseases such as ocular pemphigoid, or allergic reactions. Rarely entropion can be present at birth. Entropion should be repaired surgically before the rubbing damages the cornea by causing infection and scarring. Prior to surgery, the eye can be protected by taping and pulling the lower lid outward and using lubricating drops and ointment. In mild cases of entropion, sutures can be placed through the lower eyelid to restore the position of the eyelid. The suturing procedure can be done at the office. The surgery to repair more severe entropion is usually performed under anesthesia as an outpatient. In most cases, your doctor will tighten the eyelid and its attachments. Post-operative care includes placing an antibiotic ointment for about a week. After your eyelids heal, your eye will feel more comfortable. The risk of corneal scarring, infection and loss of vision will greatly decrease.
Eyelid Turning Out (Ectropion)
Ectropion is the medical term used to describe sagging and outward turning of the lower eyelid and eyelashes. The margin of the eyelid and the eyelashes evert (turn out). Because the back side of the eyelid needs constant lubrication by the tears on the surface of the eye, and the out-turning eyelid is not in contact with the eyeball, the back side of the eyelid becomes dry and irritated. Often it gets beefy red and can no longer protect the lower part of the eyeball including the cornea. Also, the tears drain at the lower eyelid margin close to the nose, down to the tear duct. When lower eyelid margin is turned out, the proper drainage of the tears is impaired. Therefore, ectropion can lead to dryness of and damage to the cornea, irritation and excessive tearing,
Most cases of ectropion are due to eyelid tissue laxity as a result of aging. Some cases result from scarring of the eyelid skin caused by chemical and thermal burn, trauma, skin cancers, or previous eyelid surgery. Ectropion should be repaired surgically before damage to the cornea leads to infection and scarring. Prior to surgery, the eye can be protected by taping and lifting the lower lid and using lubricating drops and ointment. The surgery to repair entropion is usually performed under local anesthesia as an outpatient. In most cases, your doctor will tighten the eyelid and its attachments. Post-operative care is similar to entropion repair, using an antibiotic ointment. The goal of the surgery is to provide comfort of the eye and to prevent corneal damage, infection and potential loss of vision.
