Eyelid Turns In or Out (Ectropion or Entropion)

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KEY POINTS

• Ectropion happens when your eyelid, usually the lower eyelid, turns out away from your eye. This can lead to drying of the front of your eye, and may increase your risk for an infection.
• Entropion happens when your eyelid, usually the lower eyelid, rolls in towards your eye. The edge of your eyelid and eyelashes can rub against the surface of your eye and irritate it and lead to scarring of the surface of your eye.
• Treatment may include artificial tear drops and ointment, eyelash removal, medicine, or surgery.

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What is ectropion or entropion?

Normally the upper and lower eyelids rest comfortably against the surface of your eye. They help to protect the surface of your eye and keep it moist and lubricated with your tears.

Ectropion happens when your eyelid, usually the lower eyelid, turns out away from your eye. This can lead to drying of the front of your eye, and may increase your risk for an infection.

Entropion happens when your eyelid, usually the lower eyelid, rolls in towards your eye. The edge of your eyelid and eyelashes can rub against the surface of your eye and irritate it. If not treated, entropion can lead to long-term tearing problems and scarring of the surface of your eye.

What is the cause?

Problems with your eyelids turning in or out may be caused by:

• Eyelid tissue that loosens as you get older
• Scar tissue that forms after an injury, surgery, sun damage, or skin cancer
• Loss of muscle tone from damage to the nerves that control the muscles in your face and eyelids
• Eyelid spasms, swelling or irritation of your eye

What are the symptoms?

Symptoms may include:

• Dry, red eyes that feel scratchy
• Watery eyes
• Gritty feeling or sharp pain in your eyes
• Decreased vision or blurry vision

How is it diagnosed?

Your eye care provider will ask about your symptoms and medical history and do exams and tests such as an exam using a microscope with a light attached, called a slit lamp, to look closely at the front and back of your eye. Your provider may also take photographs to document the appearance of your eyelids and to help in your follow up care.

How is it treated?

For mild problems, artificial tear drops and ointment may keep your eye comfortable.

Special skin tape can help pull the edge of your lid and eyelashes away from the surface of your eye. This makes your eye feel better, but does not correct the problem.

Your healthcare provider may also recommend the removal of several eyelashes to prevent them from irritating your eye. This can be done with special tweezers, heat treatment, or laser treatment.

If the problem is caused by a spasm, a very small amount of a medicine called botulinum toxin A can be injected into the muscles that close your eyelids. This may weaken or stop the muscle spasms for several months. The shots need to be repeated to keep spasms under control.

Your healthcare provider may recommend surgery to tighten your eyelid. This may be done with or without a skin graft, often using a small piece of the extra skin of your upper eyelid.

How can I take care of myself?

Follow the full course of treatment your healthcare provider prescribes. Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I prevent eyelid problems?

Eyelid problems usually cannot be prevented. However, regular eye exams will allow your eye care provider to start treatment earlier.