Eyelids are usually taken for granted, unless a problem develops. It’s important to understand that the eyes are supported by the eyelids and surrounding structures. Properly functioning eyelids are essential in having a clear vision and comfortable eyes. Several conditions can target the eyelids and ultimately affect our vision.
Ectropion and entropion are two common eyelid problems that become more prominent with age and typically require surgery. Both conditions can be painful and result in complications like permanent scarring of the cornea, eye infections, dry eyes, and even vision loss.
Ectropion is a medical eye condition in which the eyelid flips away from the eye surface and exposes the lining to possible irritants. This condition can cause significant dryness on both the eye and the inner lid, leading to redness and irritation to the cornea and inner lining. It is more common in older adults and usually affects the lower eyelid. Severity can range from a small portion to the entire length of the eyelid being affected. Symptoms can include blurry vision, burning, stinging, a red and watery eye, and discharge. In some circumstances, the eye can be difficult to open in the mornings.
Entropion is similar to ectropion, but the eyelid flips inward. This leads to the lashes rubbing against the surface of the eye, causing major irritation and discomfort. The eyelid can get stuck inward or it can happen when the patient blinks hard or squeezes the eyes shut tightly. Just as with ectropion, entropion is more common in older adults and typically affects only the lower eyelid. Symptoms include a foreign body sensation, irritation, crusting, watery eyes, redness, and discharge. When the eyelid is not functioning properly, it exposes the eye to a greater risk of infection.
The eyelids are held in position by ligaments and connective tissue that can be weakened as we age. Collagen and elastin are naturally produced by the body and give us a youthful look. However, with aging, the body makes less of these products and problems can begin. Frequent rubbing of the eyes can also stretch out the eye ligaments and accelerate the aging process of the eyelids. Ectropion occurs when the eye is more prominent; whereas, entropion is usually a result of deep-set eyes. Scar tissue, skin cancer, and autoimmune skin diseases can also contribute to these very uncomfortable and troubling conditions.
Both ectropion and entropion require surgical intervention on an outpatient basis under either local or IV sedation. The type of repair depends on the exact nature of the problem, but most cases get successfully fixed with board-certified oculoplastic surgeon Dr. Vivian Schiedler reattaching the ligaments inside the lower eyelid. Horizontal tightening at the outer corner of the eye may also be performed to aid in healing. Skin grafts may be necessary in rare cases. This technique is reserved for patients who have significant scarring or tissue loss from previous surgery or trauma. Prior to surgery, Dr. Schiedler will review your current medications to limit the complications from drug interactions, like prolonged bleeding from blood thinners.
Following surgery, cold compresses can be used to decrease swelling and strenuous activity should be reduced for at least a week post-surgery. Since blurry vision can be a side effect of any eye ointment used, it is a good idea to take a few days off from work.
Most patients enjoy excellent and long-lasting results after entropion and ectropion surgery. However, it is fairly common to develop entropion or ectropion on the unaffected eye months or years later. The severity of the cases differs, but complex cases are usually ones that need skin grafting or oral medications to control autoimmune conditions. If you fall into this category, Dr. Schiedler will work with dermatology and rheumatology colleagues to help manage these conditions.
If you suffer from either ectropion or entropion, contact oculoplastic specialist Dr. Vivian Schiedler at Oasis Eye Face and Skin to prevent further irritation or damage to your eyes. Oasis Eye Face and Skin offers highly specialized reconstructive and cosmetic surgery of the eyes and brows. Meticulous and delicate care is taken to achieve eye comfort restoration, rejuvenation, and natural-looking results that preserve and enhance your appearance. Contact Dr. Schiedler at (541) 708-6393 and schedule your consultation today!