Entropion and Ectropion
An entropion is an inward rotation of the lid (usually lower lid) such that the lashes tend to rub against the eye.
An ectropion is an outward turning of the lower eyelid away from the eye.
Most cases of entropion result from the normal consequences of ageing but other cases include certain eyelid inflammations, infections or injuries. The entropion may be constant or intermittent. In cases due to infections and inflammations, treatment of the underlying cause usually improves or eliminates the entropion. More severe cases, especially with significant risk of lash irritation to the eye, require surgery to restore the lid to its proper position.
A chronically turned in eyelid can result in acute sensitivity to light and wind, and may lead to eye infections, corneal abrasions, or corneal ulcers. If an entropion exists it is important to have it repaired before permanent damage occurs to the eye.
An ectropion is an outward turning of the lower eyelid away from the eye. This may also occur as a normal consequence of ageing in some individuals but can also result from various inflammations as well as chemical and thermal burns. Troublesome symptoms such as excess tearing, burning and irritation can occur.
Symptoms of entropion include irritation, foreign body sensation, tearing, discharge and blurred vision. It is usually apparent by direct inspection that the lower lid edge has turned inward.
The diagnosis of ectropion is usually readily apparent - all or part of the lower lid is drawn away from the eye. When the tear drainage punctum at the nasal corner of the lid is turned outward significantly, tears seem to overflow the lid.
Risks of surgery
All surgery carries some uncertainty and risk When eyelid surgery is performed by a qualified oculoplastic surgeon, complications are infrequent and usually minor.
Nevertheless, there is always a possibility of complications, including infection or a reaction to the anaesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery.
Preparing for surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
Types of anaesthesia
Eyelid surgery is usually performed under local anaesthesia - which numbs the area around your eyes. You may choose to have sedation (twilight anaesthesia). The anaesthetic options will be tailored to your individual needs and will be discussed with you before your surgery.
The usual treatment for entropion and ectropion involves tightening of the eyelid and it’s attachments to restore the lid to its normal position. A small incision is made in the laugh lines at the outer corner of the eye. Through this the tendons and muscles of the eyelid are tightened and repositioned, the skin is closed with fine absorbing stitches.
You will be required to use eye drops and an eye ointment for a few days post-operatively to aid the healing process and prevent infection. You may need a dressing on the eye for 12 to 18 hours
Getting back to normal
Most patients experience immediate resolution of the problem once surgery is completed with little, if any, post-operative discomfort. Any minor bruising or swelling should be gone after a couple of weeks.
The new look
After your eyelid heals, your eye will feel comfortable and you will no longer have the risk of corneal scarring, infection, or loss of vision.