Ectropion and Entropion

What are Ectropion and Entropion?

Ectropion and entropion are conditions where the lower eyelid turns outward or inward, respectively. These changes in eyelid position can lead to significant discomfort, eye irritation, and, if left untreated, may affect vision and the health of the eye surface. Fortunately, both conditions are highly treatable, often with a straightforward surgical procedure.

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Ectropion (Outward Turning of the Eyelid)

Ectropion occurs when the lower eyelid turns away from the surface of the eye, leaving the eye exposed. This prevents normal tear drainage and allows air and wind to irritate the eye surface.

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Common Symptoms of ectropion:

• Watering (due to poor tear drainage)

• Red, irritated or gritty eyes

• Sensitivity to wind or light

• Crusting or discharge

• A visible gap between the eyelid and eye 

 

Causes of Ectropion:

• Involutional (age-related): The most common cause, due to weakening of the eyelid’s support structures over time.

• Cicatricial (scarring): Caused by scarring or skin tightening, which may result from surgery, trauma, burns, or chronic inflammation.

• Facial nerve weakness (e.g. Bell’s palsy): Can lead to laxity and sagging of the lower lid.

 

Treatment:

• Involutional ectropion is usually corrected by tightening the eyelid with a short surgical procedure under local anaesthetic.

• Cicatricial ectropion may require a skin graft to replace missing or tight skin and restore the eyelid to a natural position. The graft is typically taken from the upper eyelid or behind the ear.

 

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Entropion (Inward Turning of the Eyelid)

Entropion occurs when the lower eyelid turns inwards, causing the eyelashes and skin to rub against the surface of the eye. This can be uncomfortable and, over time, may damage the cornea (the clear front surface of the eye).

 

Common Symptoms:

• Irritation, burning, or a scratchy sensation in the eye

• Red or watery eyes

• Sensitivity to light and wind

• Repeated eye infections or inflammation

• Feeling like something is in the eye

 

Causes of Entropion:

• Involutional (age-related): The most common type, caused by loosening of the eyelid muscles and tendons with age.

• Cicatricial: Due to scarring or contraction of the inner eyelid surface, which can pull the lid inward.

• Congenital or spastic: Less common causes seen in younger individuals or following eye irritation.

 

Treatment:

• Entropion can be treated surgically with a procedure to tighten and reposition the eyelid, restoring it to a more natural outward-facing position.

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What to Expect After Surgery

• Most procedures are performed as day cases under local anaesthetic

• Mild bruising and swelling are expected and usually resolve within 2 weeks

• Sutures are typically dissolvable, and take up to 4-5 weeks to disappear

• Surgery is highly effective at relieving symptoms and improving comfort and eye protection

• Patient can return to their normal activities 2 weeks after surgery

 

Why Choose an Oculoplastic Surgeon?

Eyelid malposition surgery requires a precise understanding of the eyelid’s structure and function. As an ASOPRS-trained and BOPSS-member oculoplastic surgeon, Miss Ting specialises in eyelid surgery and has experience managing both straightforward and complex cases, including those involving skin or mucosal grafting. Her approach is tailored, modern, and focused on restoring both comfort and eyelid function safely.