Entropion is an eyelid malposition characterized by in-turning of the eyelids. This more often affects the lower eyelids, but some conditions can also involve the upper eyelids as well. This can be a challenging issue to address and requires expert understanding and surgical “familiarity” with eyelid tissue manipulation to achieve an effective and long-lasting cure. This most often is an age-related issue, but there are several serious eye diseases that can also be the cause and require a careful eye exam and sometimes specialized tissue testing of the conjunctiva. In age-related cases, it is characterized by laxity of the eyelid margin, over-riding orbicularis (eyelid muscle), and disinsertion of the eyelid retractors deep in the eyelid. If all three issues aren’t addressed, then a long-term success won’t be achieved. Dr. Burroughs is often referred this problem from general ophthalmologists and other plastic surgeons from failed prior surgical attempts.
Ectropion (shown is “tarsal ectropion” – a severe form) is characterized by out-turning of the eyelid margin. It is often accompanied by simultaneous eyelid retraction or excessive “pulling” of the eyelids widely apart. It is also mostly a involutional “age-related” issue, but it can also be due to trauma, birth defects, and various skin diseases. Most commonly, it can be repaired with just a couple of properly placed sutures at the outer corner of the eyelids, but sometimes correction of lower eyelid retraction is also required and/or skin grafting for more severe cases. Dr. Burroughs has adopted several techniques to repair this issue, and some of them can be done “invisibly” through an upper eyelid lift, thereby avoiding extra skin incisions. Shown is a before/after patient following correction of lower eyelid ectropion and retraction.