Entropion (pronounced en-'trO-pE-"än) is the medical term used to describe a condition where the lower eyelid and eyelashes turn or roll inward towards the eye. This causes the eyelid and its lashes to constantly rub against the cornea (the front part of the eye) and conjunctiva (the mucous membrane that protects the eye).

Entropion is usually due to a relaxation of the tissues of the eyelid as a result of aging. It is most often seen in elderly people when the structures supporting the lower eyelid stretch. This stretching permits the lower eyelid to turn inward. Entropion may also be caused by inflammation or scarring on the inner surface of the eyelid, by eyelid injuries, or by tumors. Rarely, entropion is present at birth (congenital) if the eyelids do not form normally.

Entropion can cause chronic irritation to the eyelid and the eye. This can result in excessive tearing, crusting of the eyelid and mucus discharge, a feeling that something is in the eye, irritation of the cornea, and impaired vision. With entropion, the lower eyelid lashes may rub against the surface of the eyeball, which can damage the cornea (the clear part of the eye that allows light to enter the eye) and cause infection and scarring. It is important to have this condition repaired before permanent damage occurs to the eye.

The usual surgery for entropion involves tightening of the eyelid and its attachments to restore some of its elasticity and to reposition it normally. There are a number of surgical techniques for successfully managing entropion. The surgical procedures are usually performed on an outpatient basis using a local anesthetic and monitored sedation. If a patient is not able to undergo surgery, tape or sutures can be used to temporarily reposition the eyelid and to protect the eye. Lubricating drops and ointments for the eye are also helpful. Entropion seen in babies usually resolves spontaneously within a few months, but occasionally needs to be treated. Other factors that contribute to the presence of an entropion may require special treatment. Medications are frequently used to control inflammation or infection and to treat scars. Scar excision and tissue grafts may also occasionally be necessary.

Ectropion (pronounced ek-'trO-pE-"än) is the medical term used to describe an abnormal eyelid that turns outward and no longer touches the eye. As a result, the conjunctiva (the mucous membrane that lines the eyelid) may become red and exposed. This condition usually involves one or both lower eyelids but may rarely affect the upper eyelids.

Ectropion is usually due to relaxation of the tissues of the eyelid as a result of aging. It is most often seen in elderly people when the structures of the lower eyelid stretch and permit the lower eyelid to turn outward. Ectropion can develop at any age, however.

Ectropion can also arise as a result of undetected skin cancers pulling down the eyelid. Eye trauma may also result in ectropion. Ectropion may also result from scar tissue that has been formed from injury or from facial surgery that contracts and stretches the eyelid skin. Ectropion may develop from facial nerve palsy (Bells palsy), in which the muscles surrounding the eye (and other facial muscles on that side of the face) are paralyzed. Finally, ectropion may be further aggravated due to constant wiping by the tearing patient, which tends to pull the eyelid further from the eye.

Ectropion can cause chronic irritation to the eyelid and the eye. This can result in excessive tearing, crusting of the eyelid and mucus discharge, infection, irritation of the cornea (the front part of the eye), and impaired vision. When the lower eyelid is turned outward it no longer touches the eye. Because of this, the eyelid cannot properly spread the tear film across the eye which leads to poor drainage of tears through the nasolacrimal (tear drainage) system. The exposed inner lining of the eyelid becomes dry and inflamed. As a result, the eye may become damaged.

To prevent dryness of the cornea because of inadequate lubrication of the eye, artificial tears and lubricating ointments may be used to keep the cornea moist. A protective shield may be worn at night to keep moisture in the eye. If the ectropion is due to laxity of the eyelid's supporting structures, it is best treated surgically. Surgery can reposition the eyelid back to its normal position against the eye. Sometimes, a skin graft may be necessary, especially in cases of trauma or scarring of the skin. This can be accomplished by tightening the eyelid and its attachments to restore some of its elasticity and to reposition the eyelid. The surgical procedures are usually performed on an outpatient basis using a local anesthetic and monitored sedation. If the ectropion is a result of scarring, skin cancer, trauma, facial nerve palsy, or some other factor, treatment of the underlying condition may be done before or at the same time the ectropion is repaired.

For entropion and ectropion repair, recovery time is relatively short. For most people, pain is minimal but medication will be prescribed. As with any medical procedure, there may be risks that should be discussed with your surgeon.