Conditions of the eyelid can affect the health of the eyes as well as a person’s sense of confidence. Entropion and ectropion are two eyelid conditions for which treatment is available. If your eyelids sag away from your eyes or turn inward toward the eyes, you can find the help you need in our Denver office.
Ectropion denotes an eyelid that hangs away from the eye, while entropion describes an eyelid that is turned toward the eye so that the lashes constantly rub the surface.
What Is Entropion?
Entropion is the eyelid condition that is characterized by an inward turn of the tissue on the lower lid. When tissue turns inward, the eyelashes may be felt against the eyeball and can be very painful. The persistent friction of the lashes against the front surface of the eye could cause corneal inflammation and irritation, and sometimes dangerous ulcers of the cornea.
What Causes Entropion Eyelid Condition?
Entropion typically occurs due to laxity of the eyelid support tendons or from scarring in the inner lining of the lower eyelid. This condition is more common among older individuals, possibly because collagen strands break down with age and the body does not produce sufficient collagen to rebuild the matrix that supports the skin. Without adequate support, the eyelid can rotate against the eye.
What Are the Symptoms of Entropion?
Initial symptoms of entropion may be mild and infrequent. However, over time, as the eyelid turns further inward, symptoms increase in frequency. Eventually, they may be constant. Indications of entropion include:
- Foreign body sensation, as if something is in the eye
- Excessive tearing
- Light sensitivity
- Discharge from the eye
- Eye pain
- Blurred vision
What Is Ectropion?
Ectropion could be called the opposite of entropion. This condition is characterized by an outward turn of the eyelid, usually the lower lid. The degree of turning may vary: it can include one segment of the lower eyelid, or instead the entire lower eyelid.
What Causes Ectropion Eyelid Condition?
Ectropion may relate to laxity of the eyelid support tendons and/or muscle weakness in the muscles that secure eyelid tissue against the eyeball. Muscle weakness may relate to the natural aging process, infection or injury to the muscle of the lower eyelid, or to facial paralysis caused by a medical condition such as Bell’s palsy. In some instances, ectropion is associated with a genetic disorder such as Down’s Syndrome or to a benign or cancerous growth on the eyelid. Sometimes, ectropion is caused by trauma, scars of the eyelid or cheek, or from surgery.
What Are the Symptoms of Ectropion?
Ectropion causes tearing symptoms by inhibiting the proper drainage of tears from the eye into the nose. In addition, with ectropion, the eyelid can’t properly protect the eye, which is more exposed to the air and can become irritated. Some of the symptoms include:
- Excessive watering due to the accumulation of tears in the eye
- Dry eye syndrome, which feels gritty and sandy
- Light sensitivity
Will Entropion or Ectropion Eye Conditions Affect My Sight?
Both entropion and ectropion can affect eyesight by causing injury to the cornea. Ongoing irritation and inflammation in this front part of the eye could lead to permanent vision loss.
Who Is at Risk for Developing Entropion or Ectropion?
Age is a primary risk factor for entropion and ectropion, as is an eye injury or previous eye surgery. Furthermore, people who have had certain eye infections, such as trachoma, have a higher risk for entropion.
Treatment for Entropion and Ectropion Eye Disorder
Entropion and ectropion treatments are both treated definitively with outpatient eyelid surgery. The exact details revolve around the cause of the turned eyelid, the extent of turning and the severity of symptoms. Sometimes, temporary treatment involves medications or contact lenses to keep the eyes properly lubricated and soothed.
Entropion may be temporarily relieved with Botox injections, a special transparent skin tape, or stitches. Stitching the inward-turned eyelid may temporarily hold the eyelid in the proper position for several months. Usually, the eyelid eventually turns back toward the eye.
Surgery to Treat Entropion and Ectropion
For full and lasting correction of either eyelid problem, surgery is usually the best treatment available. The type of surgery that is conducted depends on the cause of the problem and the condition of tissue around the eye. For both conditions, the typical person would have outpatient eyelid surgery that takes 20-60 minutes under local anesthesia and intravenous sedatives.
Entropion surgery may involve the removal of a slight amount of eyelid tissue to tighten the muscles and tendons that hold the eyelid against the eye. Grafting may be necessary if entropion is caused by scarring after an eye injury or surgical procedure.
Ectropion surgery is also dependent on the cause of the eyelid turn and the condition of tissue around the eye. Treatment may involve the removal of a small section of the lower eyelid and tightening of underlying tendon and muscle. In instances of scarring, a tissue graft may need to be performed.
Recovery from Reconstructive Eyelid Surgery
Recovery from eyelid surgery is generally mild. Patients are usually instructed to apply antibiotic ointment several times a day for the first week. Prescription or over-the-counter pain medication can be taken as directed to soothe discomfort. The outer corner of the eye is commonly tightened and elevated but returns to a more normal position within the first two weeks after surgery. Sutures are usually removed after the first week of healing. By the end of two weeks of recovery, the majority of swelling and bruising should be gone and the patient can resume most normal activities.
Dangers of Untreated Entropion/Ectropion
The eyelids provide vital protection to the ocular surface. Pulling away or turning inward alters the natural environment in which tear distribution and drainage occur normally. Without treatment, eye irritation may increase to such an extent that the cornea suffers permanent damage.