Other Eyelid Malpositions
There are several conditions that may cause the eyelid to become incorrectly positioned. Beyond the aesthetic factor, these malpositions usually need to be corrected because they can result in decreased vision and irritation of the eye. The major causes of eyelid malpositions are:
Ptosis is a condition in which the eyelid droops. It is caused by a weakness of a muscle deep within the eyelid. Ptosis does not involve excess skin or tissue in the eyelid. It is usually a result of aging, but some people develop ptosis after eye surgery or an injury, and some children are born with the condition. A brief surgical procedure can eliminate the drooping by lifting the eyelid and reattaching it to a higher location. Patients who are also suffering from excess skin may choose to undergo blepharoplasty at the same time as ptosis repair. Please see a full description of this procedure under “Ptosis Repair”.
Entropion is a "turning in" of the eyelid. The lid and lashes rub painfully against the cornea, which is the very sensitive surface of the eye. Entropion usually occurs as a result of aging, but other causes can include injury, congenital defects and various inflammatory conditions. A spasm can cause the lid to turn inward as well. Entropion can often be corrected with a brief surgical procedure in the office under local anesthesia. In some cases, surgery may involve the removal of a small section of the eyelid to tighten the lid and correct eyelid laxity. It is also important to rule out any scarring on the inside of the eyelid that may be causing the eyelid to turn in, such as a condition known as ocular cicatricial pemphigoid. Your doctor will determine which type of entropion you have on your initial visit and recommend treatment accordingly.
Ectropion is a "turning out" of the eyelid that causes redness, irritation, tearing and an increased likelihood of infection of the eye. Common causes of ectropion include aging, sun damage, tumors, burns and the removal of too much skin during blepharoplasty. Over time, if the condition is not treated, the cornea may become damaged due to abrasions, ulcers or infections, resulting in some loss of vision. Artificial tears can help provide temporary relief from dryness. Ectropion can be corrected with a simple procedure under local anesthesia (often with sedation) in which the eyelid is tightened. If the ectropion is due to scarring or other causes of tightening of the lower eyelid such as a skin tumor or burn, a skin graft may be required to bring the eyelid to the natural position. Your doctor will fully explain your condition and treatment at your initial visit.