Entropion and Ectropion


I’m Dr. Matheson Harris with
Utah Oculoplastic Consultants in Salt Lake City. I commonly see patients with
lower eyelid problems causing tearing, eye irritation,
and blurred vision. The most common types occur when
the eyelids become loose and either roll in toward
the eye or outward. When eyelids roll in, this
is called entropion. It causes the eyelashes to
rub against the eyeball. This can be painful and cause
you to tear excessively. It may also cause breakdown of
the surface of your cornea, which can lead to a corneal
ulcer and decreased vision or a loss of vision. When the eyelids roll out
away from the eye, this is called ectropion. And it’s usually easier to spot
because the lower eyelids will appear droopy, the eyelid
margins may look red, and the eyes can become bloodshot. Because the eyelids are unable
to properly drain away your tears, they’ll pool up
on the lower lids and stream down your face. Fixing these two problems
involves tightening up your lower eyelids and placing
sutures that will return them to their proper position. To fix entropion, an incision is
made near the middle of the eyelid and a portion of the
redundant eyelid is removed. The cut ends are rejoined and
then special rotating stitches are placed to roll that lid back
outward and return the eyelashes to their
normal position. The eyelid is then covered in
ointment and the patient ices it for a few days. You can expect bruising and
swelling, which will take a week or two to resolve. Most patients have
very little pain. To correct ectropion or an
eyelid that is rolled out, the eyelid is tightened through an
incision at the outer corner of the eye. The eyelid is shortened and
heavy sutures are used to reattach it firmly
to the bone. Occasionally, we also need to
raise up the cheek to support the lower eyelid. This is done through the same
incision and helps to take the weight of the cheeks off
the lower eyelids. At the end of your surgery,
you will put ice on the incisions for 48 hours and
use ointment for a week. All the stitches we place are
absorbable and will fall out on their own. There’s little pain with this
procedure, but some patients will have tenderness at the
corners of their eyes until the stitches have completely
resorbed. After either surgery, we’ll see
you back within a week and then six weeks later to ensure
you’ve healed well and are happy with your result. Complications with these
surgeries are uncommon, but can occur. Because sutures are delicate,
they can occasionally break and the incisions may open. If this happens, call our
office as we may need to replace them. Some patients bleed
after surgery. And in most cases, just holding
direct pressure on the area will stop the bleeding
within a few minutes. If after 10 minutes the bleeding
won’t stop or is particularly heavy,
call our office. Any sudden an increase in pain
or new discharge or decrease in vision should be brought to
our attention immediately. Taking it easy for the first
week or two, using the ointment as prescribed, and
not rubbing your eyes will help you avoid most
of these problems. Thank you for choosing Utah
Oculoplastic Consultants. We look forward to helping you
look and feel your best.

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