Eyelid Malposition (Ectropion & Entropion)

The lower eyelid – and rarely also the upper eyelid – can be prone to turning outwards or inwards. When the lower eyelid turns outward and droops down (ectropion), this can cause a permanent appearance of redness of the tissue below the white of the eye, and can lead to dryness of the eye with irritation. Sometimes all you will see is more white of the eye showing below the colored part of the eye (iris) compared to the other side. Ectropion can be caused by aging from laxity of the skin, or from prior surgery or cancer removal in the cheek area (cicatricial ectropion), or by paralysis of the facial nerve (Bell’s palsy).

If the lower eyelid turns inward (entropion), the eyelashes will point toward the eye and cause significant irritation, foreign body sensation, and possibly tearing. This can also be due to aging or scarring from prior surgery.

The Procedure

Dr. Eftekhari can fix eyelid malposition (ectropion and entropion) as an outpatient surgical procedure, or possibly as an office procedure under local anesthesia depending on the severity of the malposition.

Dr. Eftekhari will begin by numbing your eyelid with lidocaine or a similar anesthetic to perform the surgery. After preparing the area, the surgery is performed most commonly by tightening the lower eyelid at its outer corner in order to address any laxity that is contributing to the drooping of the eyelid. The eyelid is tightened to the lining of the bone and, after surgery, the incision hides very well in the natural crease at the corner of the eyelid. In rare occasions, Dr. Eftekhari may need to anchor the eyelid to the bone through small openings in the bone.

Recovery from the Procedure

After eyelid malposition surgery, Dr. Eftekhari will prescribe antibiotic eye ointment to be used twice a day on your incisions for two weeks. In addition, artificial tears 4-6 times a day will also help with irritation. There can be bruising and swelling after this surgery lasting up to 1-2 weeks. The stitches dissolve on their own and do not need to be removed.