When Eyelids Turn the Wrong Way
For various reasons, sometimes a person’s eyelid can turn the wrong way. In some cases the eyelid “turns in”. In others it “turns outward.” These conditions can lead to pain, irritation, and problems with tear drainage. Our team at Central Valley Eye Medical Group can correct both of these eyelid conditions with surgery.
Entropion is the term for when the eyelid “turns in.” This usually occurs on the lower eyelid. The lid may be turned inward at all times, or only when the eyelids are closed tightly. Either way, when this happens the skin and lashes rub on the cornea, which can be very painful. It can also make the eye sensitive to light and wind.
Causes of entropion
In most patients, entropion is simply a result of aging, as the muscles around the eyes can weaken. A spasm or simple relaxing of the muscles near the eye can cause the lower eyelid to turn inward. Other causes can be injury to the lid, a congenital defect, skin infections or certain inflammations. People who have had facial surgery, particularly in the mid-face, are more prone to entropion.
There are non-surgical options to remedy entropion such as lubricating eyedrops, Botox injections, even strategically placed stitches. But usually entropion needs to be corrected with outpatient surgery by one of our Central Valley Eye Medical Group surgeons. They perform surgery to reposition the lid or lids with the condition.
The area is numbed with local anesthetic, sometimes with light sedation depending on the patient. If the entropion is due to muscle weakness, we may remove a small section of the eyelid to tighten the muscles in the area. If entropion is due to scars from injury or a prior surgery, it’s likely we will utilize a skin graft in order to reposition the eyelid.
In contrast to entropion, ectropion is a “turning out” of the eyelid. Again, this typically occurs on the lower eyelid. The sagging skin of the inner eyelid is exposed, either in one part of the lid or across the entire lid. When ectropion happens this prevents tears from draining correctly out of the eye, leading to chronic tearing, redness, pain, a gritty feeling, crusting of the eyelid, mucous discharge, even a breakdown of the cornea.
Like entropion, ectropion is usually a result of the muscle weakness that comes with age. But ectropion can also result from nerve damage, sun damage, tumors, burns, or eyelid surgery (blepharoplasty) where too much skin was removed. The condition can also be congenital.
Artificial tears can provide temporary relief from the dryness that accompanies ectropion, but surgery is usually necessary to fix the condition. The surgical options/methods are similar to those for entropion. If muscle weakness is the cause, a small portion of the eyelid may be removed and the muscles tightened. If too much skin was removed during blepharoplasty, a skin graft will be necessary.
Correcting entropion or ectropion involves relatively straightforward surgery, but these aren’t procedures to trust to cosmetic surgeons. Our surgical team at Central Valley Eye Medicals is highly trained with eye surgery and they can correct these eyelid problems. If you have problems with an eyelid that is turning the wrong way, please call us at (800) 244-9907 to schedule an appointment.
Posted in: Eye Conditions