What is the difference between ectropion and entropion?

Ectropion refers to an out-turned lower eyelid. Ectropion can occur for three different reasons. The most common is age-related involutional ectropion, where there is excessive laxity in the lower eyelid. The next most common type is paralytic ectropion, where there is partial or complete paralysis of the facial muscles, such as after a stroke or from Bell’s palsy. The third type is cicatrial (scarring) ectropion, caused by trauma related scarring or skin diseases with tightening of the skin.

Symptoms include: tearing, mattering of the lashes, irritation, and erythema (redness) of the lower lid.

Involutional (age-related) and paralytic ectropion are repaired with a lower lid tightening procedure. Think of it as a “nip and tuck” for the lower eyelid. This is performed as a same day surgery with light sedation and local anesthesia. Cicatricial ectropion is a bit more complicated to repair. A cheek lift is usually needed to recruit extra skin in addition to lower eyelid tightening.

Entropion refers to an in-turned lower eyelid, where the lashes are rubbing against the eyeball. This can be quite irritating to a patient, and if left untreated, can cause permanent damage to the cornea and loss of vision. Involutional (age related) is the most common type of entropion. This is caused by vertical laxity in the lower eyelid retractors (muscles that pull the lower lid down and back) combined with horizontal laxity in within the lower eyelid.

Symptoms include, chronic redness, irritation, tearing, foreign body sensation, and loss of vision.

Entropion repair is performed as a same-day surgery with light sedation and local anesthesia. Treatment is aimed at tightening the lower eyelid retractor muscles as well as a “nip and tuck” to the lower eyelid.