Entropion & Ectropion Repair
Repair of eyelid malposition (ectropion or entropion) involves tightening of the lateral aspect of the eyelid (lateral tarsal strip). The procedure involves tightening the lower eyelid and may require an additional incision in the conjunctiva to correct the eyelid position. If your eyelid has been out of position for a long time a suture in your lower eyelid will be required to stabilize your eyelid for as long as 14 days post-operatively. |
Surgical risks include:
- post-operative scarring
- granuloma formation
- asymmetry
- undercorrection or overcorrection
A bump in the lateral aspect of the eyelid is normal, that is the suture holding the eyelid up. This suture is not visible and will dissolve over several months. |
|
Ectropion
Introduction: Ectropion is an eyelid malposition in which the lower eyelid turns outward and does not touch the eye. Consequently, the conjunctiva can become exposed and red. Ectropion usually affects one or both of the lower eyelids and rarely the upper eyelids.
Description: Ectropion usually results from relaxation of eyelid tissues due to aging changes. It can also occur because of undetected skin cancers that pull down the eyelid. Other causes of ectropion include trauma, contraction of scar tissue of the surrounding skin, and eyelid or facial surgery. It may also occur congenitally or secondary to facial nerve palsy. The condition may be worsened by constantly wiping the eyes. Eyelid burns or skin disease may also result in ectropion.
Many symptoms of ectropion are a result of chronic irritation of the eye and eyelid. Such symptoms include excessive tearing, crusting of the eyelid and mucus discharge, infection, corneal irritation, sagging skin around the eye, impaired vision, redness and pain of the eye, and sensitivity to light and wind. Ectropion may also result in poor drainage of tears through the nasolacrimal system. Also, the exposed inner lining of the eyelid becomes dry and inflamed, and the eye may be damaged.
Differential: Eyelid basal cell carcinoma, Bells palsy, floppy eyelid syndrome, ichthyosis, neuro-ophthalmic examination, neuro-ophthalmic history, eyelid squamous cell carcinoma.
Management: Artificial tears and lubricating ointments can be used to moisten the cornea to prevent dryness of the cornea. When ectropion is caused by stretching of the eyelid’s supporting structures, surgery is the best treatment to repair the involved muscle and tendons of the eyelid. Depending on the cause of ectropion, surgery can be used to reposition the eyelid back to its normal position against the eye.
Before & After Ectropion Repair
|
Entropion
Introduction: Entropion is an eyelid malposition in which the lower eyelid and eyelashes turn inward towards the eye causing the eyelid and lashes to rub against the cornea and conjunctiva.
Description: Entropion usually results from relaxation of eyelid tissues due to aging changes. It may also be due to infection or scarring on the inner surface of the eyelid, eyelid injuries, or tumors. Entropion may also be congenital if the eyelids do not form normally.
Many symptoms of entropion are a result of chronic irritation of the eye and eyelid. Such symptoms include excessive tearing, crusting of the eyelid and mucus discharge, corneal irritation, sagging skin around the eye, impaired vision, redness and pain of the eye, sensitivity to light and wind, and foreign body sensation. Corneal infection and scarring may also occur as a result of entropion.
Differential: Distichiasis, trachoma, trichiasis.
Management: Several surgical procedures may be used to tighten the eyelid and eyelid attachments thus restoring some of its elasticity and repositioning it normally. Alternatively, tape or sutures can be used to reposition the eyelid and protect the eye temporarily. Lubricating drops and ointments are also helpful. Medications may also be used to control eyelid inflammation or irritation and to treat scars. Sometimes scar removal and tissue grafts may be needed .
Entropion Picture
