Palpebral entropion malposition

The edge of the eyelid can be turned inward in contact with the eye (eyelid entropion) or outward away from the eye (eyelid ectropion).

Whether entropion or ectropion, there can be a wide variety of symptoms : discomfort, foreign body sensation, irritation, tearing, unwanted appearance, lagophthalmos (an inability to close the eyelid completely) and in advanced cases infection or even loss of vision.

In the majority of cases, entropion or ectropion is due to a palpebral hyper laxity with a relaxation of the lateral tendons which hold the eyelid on either side. They can be of congenital origin, of scar origin following a trauma, a burn or a skin pathology, of mechanical origin following a tumor, or of paralytic origin.

The lower eyelid can be compared to a hammock or a tennis net. The tennis net loosens over time, it may fall or wrinkle. Likewise, when the tendon of the lower eyelid relaxes over time due to aging or other causes, the eyelid may invert (entropion) or invert (ectropion).

Entropion means that the palpebral edge is turned inward, the eyelashes rub against the eyeball. It most commonly occurs in the lower eyelids rarely the upper eyelids. there are several etiologies for entropion that due to age is the most common, it can be post-traumatic, or post-surgical after an infection, and rarely congenital.

The eyelashes rub against the eyeball, causing irritation, redness, and a foreign body sensation. The cornea will suffer from friction, which can induce complications of varying severity :

Scratches, ulceration and in severe cases a corneal infection or abscess.

It is important for an eyelid surgeon to repair entropion to avoid complications.

Treatment of entropion is primarily surgical and the technique used depends on the etiology. The surgery is done in the majority of cases under local anesthesia. It consists of permanently returning the eyelid margin to its normal position by repairing the cause that caused entropion.

Sometimes, and for specific patients, temporary treatment with botulinum toxin injections can improve entropion for a specific period of time.

The cases proposed below allow us to better understand the operating techniques used.