Dr. Sean Paul is a master ophthalmologist in Austin, Texas who is able to diagnose and repair ectropion and entropion eyelid disorders which can lead to ulcers, scars, and other problems. 

What is ectropion and entropion?

Ectropion (an outward turning of the eyelid) and entropion (inward turning of the eyelid) are common disorders of the eyelid margin that can affect ocular function and comfort. Typically occurring on the lower eyelid, the skin of the inner lid is exposed, either in one section of eye or across the entire lid. This prevents tears from draining from the eye correctly, resulting in irritation.

Causes of ectropion and entropion

Common causes of ectropion include age-related weakening of the connective tissue around the eye, sun damage, tumors, burns, and the removal of too much skin during a lower lid blepharoplasty. In some cases, ectropion occurs as a congenital birth defect or as a result of facial paralysis. Entropion usually arises as a result of aging, since the muscles around the eyes may progressively weaken. A spasm or relaxation of the muscles near the eye can sometimes cause the lid to turn inward. Other causes can include injury, congenital defect, skin infections, and various inflammatory conditions. You may also be at higher risk for entropion if you have undergone facial surgery or have facial scarring that affects the natural curve of the eyelid.

Older woman with white hair and a white button up shirt

Problems arising from entropion and ectropion

Normally, the upper and lower eyelids close tightly, protecting the eye from damage and preventing tear evaporation. If the edge of one eyelid turns inward (entropion), the eyelashes rub against the eye, which can lead to ulcer formation and scarring of the cornea. 

If the edge of one eyelid turns outward (ectropion), the two eyelids cannot meet properly, and tears are not spread over the eyeball. These conditions are more common among older people (generally the result of increased tissue relaxation with age), among people with eye changes caused by infection, surgery, or injury, and among people who have blepharospasm.

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Both entropion and ectropion can irritate the eyes, causing a feeling that something is in the eye (foreign body sensation), watering (tearing), and redness.

Artificial tears and eye lubricant ointments (for use overnight) can be used to keep the eye moist and soothe the irritation. Entropion and ectropion can be treated surgically — for instance, to preserve sight if damage to the eyes (such as corneal ulcer with entropion) is likely or has occurred, for comfort, or for cosmetic reasons.

Surgical repair may be recommended if the patient is at risk of ocular exposure, ulceration, dermatitis, or corneal scarring. Ectropion and entropion, as well as ptosis (drooping of the upper lid), and other eyelid disorders such as lid lesions/tumors are conveniently managed by Dr. Paul at Austin Face & Body.

Common indications for ectropion repair

  • Documented ectropion with chronic eye irritation despite topical lubrication
  • Chronic keratoconjunctivitis
  • Tearing related to outflow (punctal ectropion or tear pump dysfunction)
  • Tearing related to reflex (chronic irritation)
  • Chronic dermatitis from tear irritation of periocular skin

Artificial tears can help provide temporary relief from dryness, but for a full correction of ectropion, a quick surgical procedure in which the lid is tightened may be necessary. The area is numbed with a local anesthetic, and sometimes light sedation is provided as well. For ectropion due to muscle weakness, the surgery may involve the removal of a small section of eyelid to tighten the muscles in the area. When the ectropion is caused by scars or prior surgery, the procedure may need to rely on a skin graft to allow a successful repositioning of the eyelid.

Common indications for entropion repair

  • Keratoconjunctivitis due to lashes touching the eyeball
  • Ocular irritation

Lubricating eye drops may be used to lessen certain symptoms, such as dry eyes. Temporary relief can also sometimes be found by using Botox, skin tape to hold the eyelid in place, or strategically placed stitches. But ultimately, entropion generally needs to be corrected through a brief surgical procedure in which the eyelids are repositioned. The area is numbed with a local anesthetic, and sometimes light sedation is provided for this procedure as well. Entropion surgery may also involve the removal of a small section of eyelid to tighten the muscles in the area.

Austin Face & Body

Providers who perform Eyelid Malposition (Ectropion/Entropion) treatment at Austin Face & Body

Dr. Sean Paul

Dr. Sean Paul is the founder of Austin Face & Body. As a widely published surgeon who has traveled all over the world to speak, Dr. Paul is renowned and highly regarded in his industry. He specializes in cosmetic and reconstructive eyelid and facial plastic surgery in Austin, and is board certified by the American Board of Ophthalmology.

Dr. Sean Paul »

Dr. David Gay

A passionate and highly regarded board certified surgeon who is known for incredible results, wonderful bedside manner, and selfless humanitarian work, Dr. David Gay represents everything the medical profession should be.

Dr. David Gay »

Schedule a consultation with us

If you’re experiencing any of these symptoms, please call Austin Face & Body at 512-559-3544 or contact us online to schedule a consultation with Dr. Paul. He will thoroughly examine your condition, base the diagnosis on his findings, and inform you of the best options for you.

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