Eyelids help keep eyes moist and protect them from foreign objects and intense light. When eyelids are not able to function correctly, the risk of developing eye infections, irritation and even vision loss increases. Some people have eyelids that turn in or out, known as entropion and ectropion, respectively. Both types of problems make it hard for the eyelids to effectively block debris and maintain the right level of moisture for comfort. Entropion can be very uncomfortable, as the eyelashes rub against the eyeball. Ectropion can also be rather uncomfortable, as the eye becomes dried out. Oculo-Plastic Surgeons are ophthalmologists who are specialized in reconstructive plastic surgery on the eyelids. Since they work specifically on the eyelids, they are the at explaining why you have the condition, what caused it and what can be done about it.
Causes of Entropion and Ectropion
Entropion, or turned-in eyelids, typically develops as the muscles surrounding the eyes become weak with age. This condition can also occur due to a congenital defect, inflammation, trauma to the eye or skin infections. In some cases, the eyelid turns in due to facial scarring.
Ectropion, or turned-out eyelids, can develop when the tissue surrounding the eyes gets weaker due to aging. Other causes of ectropion include congenital defects, tumors or other growths, facial palsy, sun damage or scarring caused by burns.
Reasons for Surgery to Correct Entropion and Ectropion
Eye drops can help reduce some of the discomfort caused by turned-in or turned-out eyelids, but they only provide temporary relief. Other treatment methods, such as using skin tape to keep turned-in eyelids in the correct position, are also temporary. Surgical procedures to correct entropion and ectropion provide long-term relief and help lower the risk of developing more serious conditions, such as eye infections and vision loss.
In general, most oculo-plastic surgeons recommend surgery to fix ectropion and entropion, because otherwise, the eye is at risk for serious complications like infection and scarring. Also, most of the time, the procedures to fix these problems can be done in about 45 minutes, are very safe and will provide long term relief. The procedures used to correct eyelids that are turned in or out involve the use of a local anesthetic in the affected area. Mild sedation might also be provided if the procedure is done in an outpatient center. The exact procedure that is done depends on the cause of the condition. For eyelids that are turned in or out from age-related muscle or tissue weakness, a small part of the affected lid might be removed in order to make the muscles tighter. This helps the eyelid stay in the correct position. For entropion or ectropion caused by scarring, the procedure might involve using skin grafts to hold the affected lid in the right position.
The procedures to fix ectropion and entropion are very easily tolerated. Mild soreness and bruising can occur following entropion or ectropion repair procedures. Patients might notice bruising or discoloration for about two weeks after their procedure. Taking over-the-counter medications can help relieve soreness, and avoiding strenuous activities and heavy lifting for roughly one week helps minimize bruising. Resting also helps the eyelid heal faster. The exact time it takes for patients to fully heal depends on the type of procedure done, but in general, most patients are able to go back to work in a week and feel much better withing about 6 weeks.
Risks of Entropion and Ectropion Procedures
As with all types of surgical procedures, there are certain risks. Those who are considering undergoing corrective surgery for entropion or ectropion should discuss the associated risks with an oculoplastic surgeon who specializes in performing cosmetic and reconstructive eyelid procedures. These risks are typically minimized by having patients avoid taking certain types of medication before surgery, such as aspirin and ibuprofen, and applying antibiotic ointment on the affected area to reduce the risk of infection. While serious complications can occur, they are very rare and not expected