Eyelid Malposition

The eyelids are essential for the protection of the eyes. Abnormalities of contour, strength, or position can dramatically affect ocular comfort and more importantly our vision. Two typical eyelid malposition problems are entropion and ectropion.


Entropion is the “in” turning of the lower eyelid. Entropion occurs most commonly as result of aging. Infection and scarring inside the eyelid are other causes of entropion. When the eyelid turns “inward,” the eyelashes and skin rub against the eye, making it red, irritated, watery and sensitive to light and wind. If entropion is not treated, an infection or ulcer may develop on the cornea (the clear surface of the eye). With surgery, the eyelid can be turned to its normal position, protecting the eye and improving the symptoms.

Ectropion is the “out” turning of the lower eyelid. Patients with ectropion have a sagging lower eyelid that leaves the eye exposed and dry. It is caused by a lack of tone of the delicate muscles that hold the lid taut against the eye. Excessive tearing is common with ectropion, but wiping the tears away only causes the lid to sag more. Ectropion is most common among people over the age of 60. The irritation can be temporarily relieved with artificial tears and ointments to lubricate the eye; however surgery to tighten the lid is usually necessary to correct this problem.