Eyelid Malposition (Entropion and Ectropion )

Entropion (Inward Turning of Eyelid Margin) and Ectropion (Outward Turning of Eyelid Margin)

Entropion is the condition where the eyelid margin and eyelashes turn inward. Ectropion, on the other hand, is the outward turning of the eyelid margin and eyelashes. These are the most commonly encountered eyelid malpositions in clinical practice. The primary cause is often the breakdown of connective tissues that stabilize the eyelids with age. Other causes include congenital factors, previous surgeries, trauma-injuries, certain skin diseases, radiation therapies, eyelid masses, and tumors. In cases of entropion, the inward turning of the eyelid margin and eyelashes leads to constant irritation of the eye surface. Consequently, patients may experience symptoms such as eye discomfort, burning sensation, tearing, and redness. Continuous irritation of the eye surface can lead to infections and potentially result in vision loss. Conversely, ectropion causes the eye surface to be exposed during sleep, leading to dryness initially and potentially progressing to infections and vision loss.

Treatment for both conditions is surgical. The procedure can be performed under local anesthesia, although general anesthesia may be necessary for children with congenital eyelid malformations. Depending on the cause and severity of the clinical presentation, tissue transfer from appropriate areas of the eyelid may also be required. Patients are typically discharged on the same day of surgery.