Entropion & Ectropion

Entropion

Entropion is an eye condition where the eyelid turns inward. Typically entropion occurs on the lower eyelid where the skin and lashes rub painfully against the cornea. This condition may cause the lid to either turn in constantly or only at times when the eyes are closed tightly.

Causes of Entropion

Entropion usually occurs in older adults as a result of the aging process. In adults the muscles around the eyes may progressively weaken. A spasm or relaxation of the muscles near the eye can cause the lid to turn inward. Other causes of entropion include:
  • Injury
  • Muscle weakness
  • Congenital defect
  • Skin disease
  • Inflammation
  • Surgery

Symptoms of Entropion

The initial symptoms of entropion are often the following:

  • Pain in the eye
  • Excessive tearing
  • Redness
  • Irritation
  • Pain
  • Dry eyes
  • Sensitivity to light
  • Reduced vision
  • Discharge from the eye
  • A feeling that there is something in the eye

Complications of Entropion

Over time, if the condition is not treated, the cornea may become damaged due to:

  • Abrasions
  • Corneal ulcers
  • Infection
Patients experiencing light sensitivity should contact their physician immediately. Without treatment a decrease in vision can occur. The doctor will be able to confirm the diagnosis of entropion upon an examination of the eyes.

Treatment of Entropion

While there are treatments for entropion, correction of the condition is completed with a brief surgical procedure in which the eyelids are repositioned. Temporary relief of the entropion condition can also be found with the following treatment methods:
  • Skin tape to hold the eyelid in place
  • Strategically placed stitches
  • Lubricating eye drops

Surgical Correction of Entropion

The eyelid area is numbed with a local anesthetic and a light sedation may also be provided. For 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 the entropion is caused by scars or prior surgery, the procedure typically relies on a skin graft to allow a repositioning of the eyelid.
Patients usually need to wear an eye patch for 24 hours after the surgery. Post-operatively an antibiotic and steroid ointment will need to be applied. Symptoms of entropion usually resolve immediately. There may be some short-term bruising or swelling as a result of the procedure.

Ectropion

Ectropion is an eye condition in which the eyelid turns outward. It typically affects the lower eyelid, exposing the inner lid in either one section of eye or across the entire lid. Ectropion prevents tears from draining from the eye correctly, resulting in irritation. It usually occurs in older adults as a result of the aging process, during which muscles, tendons and connective tissue around the eyes progressively weaken. Those who have had trauma to the face or eyes are at greater risk of developing ectropion.

Causes of Ectropion

In addition to aging, there are a number of causes of ectropion:

  • Facial paralysis due to Bell’s palsy or tumor
  • Facial scarring from burns or other trauma
  • Eyelid growths (malignant or benign)
  • Previous eyelid surgery (blepharoplasty)
  • Radiation of the eyelid to treat a cancerous growth
  • Excessive sun exposure
  • Rapid weight loss
  • Cosmetic laser-skin resurfacing
  • Certain eye drop medications, such as those used to treat glaucoma

In rare cases, ectropion is a congenital condition. It is usually found in infants with another genetic disorder, such as Down syndrome.

Symptoms of Ectropion

In patients with ectropion, tears do not drain properly into the small openings on the inner part of the lid (puncta). This poor drainage causes several symptoms that include the following:

  • Eye irritation and redness
  • Excessive tearing
  • Pain
  • Sensitivity to light
  • Inflammation
  • Eyes that feel dry or gritty
Patients with ectropion should be aware of its possible complications, and report any worsening of symptoms immediately.

Complications of Ectropion

Several serious complications, including the following, can result from ectropion:

  • Corneal abrasions
  • Corneal ulcers
  • Eye infections
Evidence of complications includes eye pain, sensitivity to light or rapidly increasing redness, or a decrease in vision. Any worsening of ectropion symptoms is a sign that vision is in jeopardy and emergency treatment should be sought.

Treatment of Ectropion

While there are temporary-relief treatments, such as artificial tears or soothing ointment, correction of ectropion is accomplished with a brief surgical procedure in which the eyelids are repositioned. For ectropion due to muscle weakness or scars from a previous surgery, the repair procedure may include the following:

  • Stretching of scar tissue
  • Removal of a small section of eyelid
  • Skin graft to reposition the eyelid
During recovery, an antibiotic and steroid ointment must be administered. Though there may be some short-term bruising or swelling after the operation, the symptoms of ectropion usually resolve immediately.

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