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Ectropion & Entropion

The eyelids need to be in a normal position to allow for good tear production and drainage and to allow the eyelids to close properly during each blink. When the lids are malpositioned, they can be very irritating to the eye and result in tearing, pain, and even infections. The lower lid positions can change with age, trauma, sun damage, or prior surgery. They can either be turned out (referred to as an ectropion), turned in (referred to as an entropion) or can be retracted or notched.

There are various ways a surgeon can go about repairing lower lid malpositions and it depends on the type of problem and what the etiology (or cause) is. Dr. Zoumalan will sit down with you and carefully discuss with you the options available after reviewing your history and performing a full examination.

What are the symptoms of ectropions and entropions?

The lower lid positions can change with age, trauma, sun damage, or prior surgery. They can either be turned out (referred to as an ectropion), turned in (referred to as an entropion) or can be retracted or notched. The eyelids need to be in a normal position to allow for good tear production and drainage and to allow the eyelids to close properly during each blink. When the lids are malpositioned, they can be very irritating to the eye and result in tearing, pain, and even infections.

Common Question and Answers
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    Preoperative Diagnosis:Right lower lid ectropion.

    Procedure performed: Ectropion repair, right lower lid. She underwent a right lower lid ectropion repair and using a special resuspension and tightening technique referred to as a canthoplasty. Her symptoms have resolved and now also has a normal appearing right lower lid.

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    Preoperative Diagnosis: Left lower lid ectropion.

    Procedure performed: Ectropion repair, left lower lid.

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    Preoperative Diagnosis: Left lower lid ectropion.

    Procedure performed: Left lower lid ectropion repair.

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    Preoperative Diagnosis: Right lower lid entropion.

    Procedure performed: Right lower lid entropion repair.

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    Preoperative Diagnosis: Bilateral lower lid entropion.

    Procedure performed: Bilateral lower lid entropion repair.

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    Preoperative Diagnosis: Right lower lid retraction

    Procedure performed: Repair of right lower lid retraction using a posterior spacer tissue graft and lid resuspension through canthoplasty.

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    Preoperative Diagnosis: Right lower lid ectropion and bilateral upper lid ptosis. She did not wish to have upper lid surgery so we only focused on repairing her droopy right lower lid which was resulting in tearing and ocular discomfort.

    Procedure performed: Right lower lid ectropion repair. This photo was taken 4 months after undergoing surgery.

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    Preoperative Diagnosis: Left lower lid ectropion. Note that the medial portion (closest to the nose) is everted outward so the puncta (the opening of the tear duct) is not facing the eye. This needs to be corrected otherwise the patient will complain of tearing, discomfort, and may be at risk for an ocular infection.

    Procedure performed: Left lower lid ectropion repair. The lower lid was resuspended; in addition, the medial portion of the lower lid (closest to the nose) had an additional procedure to help better invert the puncta (opening of the tear duct) in order to face the eye. The patient had resolution of his tearing symptoms and ocular irritation.

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    Preoperative Diagnosis: Bilateral lower lid ectropions resulting in tearing.

    Procedure performed: Bilateral lower lid ectropion repair. This photo was taken 14 months after undergoing surgery.

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    Preoperative Diagnosis: Left lower lid ectropion from prior eyelid skin cancer (basal cell carcinoma) resection. The removal of the skin cancer resulted in skin contracture and lid retraction near the eyelid. As a result, the patient complained of a malpositioned lid, tearing, and ocular (eye) irritation. Note that the retraction is worsened when the patient looks up (and with his mouth opened); this suggests a cicatricial (scar or shortening of the thin eyelid skin) component.

    Procedure performed: Left lower lid ectropion repair with the use of a skin graft. This photo was taken 8 months after undergoing surgery.

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    Preoperative Diagnosis: Bilateral lower lid ectropions resulting in tearing.

    Procedure performed: Bilateral lower lid ectropion repair.

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    Preoperative Diagnosis: Bilateral lower lid ectropions resulting in tearing. Note that the left is more severe than the right.

    Procedure performed: Bilateral lower lid ectropion repair, left lower lid midface resuspension (midface lift). The midface resuspension allows for better support for her lower lid position and to help prevent it from recurring months or years after surgical repair.

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    Preoperative Diagnosis: Left lower lid entropion.

    Procedure performed: Left lower lid entropion repair.

Disclaimer:

*Individual results may vary

All before and after pictures displayed are real patients who have consented to having their pictures published on our site. Individual results will vary with each patient and Dr. Christopher Zoumalan does not guarantee any outcomes of procedures shown. All pictures are meant for reference and illustrative purposes only.