Eyelid Malposition

Eyelid malposition includes a number of conditions and can affect your eye’s surface, not to mention your vision. These conditions include:

Ectropion

Ectropion describes the sagging and outward turning of the lower eyelid and eyelashes. The edge of the eyelid and the eyelashes turn out and this rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge, and irritation. During blinking, the eyelids normally sweep across the surface of the cornea and with this condition, tearing occurs because the eyelids are not able to wipe the surface of the cornea properly to pump the tears into the tear duct.

Most cases of ectropion are due to relaxation of the tissues of the eyelid as a result of aging. Some cases result from scarring of the eyelid caused by chemical and thermal burns, trauma, skin cancers, or previous eyelid surgery. Rarely, ectropion can be present at birth if the eyelids do not form properly.

Entropion

Entropion is the medical term used to describe the inward turning of the lower eyelid and eyelashes. The edge of the eyelid and the eyelashes turn in and the resulting rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge, and irritation.

Retraction

Eyelid retraction is a condition where the lid moves away from the central surface of the eye. Think of a windshield wiper on a car that is bent outward so it no longer touches the glass. This condition can be irritating in that the lid no longer functions to clean and lubricate the surface of the eye and is caused by scarring from previous surgery, thyroid disease, but is usually simply a loss of eyelid tightness with the normal aging process. Treatment of retraction involves a surgical procedure in which the eyelid is tightened. Treatment of more severe cases may require implanting a graft from the ear or other sources as a spacer to extend and reposition the lid against the eye.

Floppy Eyelid Syndrome

Floppy Eyelid Syndrome (FES) is a condition when the eyelid spontaneously inverts and is characterized by loose upper eyelids. It is a relatively uncommon condition and is often seen in overweight, middle-aged males. Some patients also suffer from obstructive sleep apnea (OSA).

Symptoms may include irritation, itching, and stringy mucous discharge, particularly upon awakening. Floppy eyelid syndrome often is unrecognized. Unsuccessful trials of eye drops such as artificial tears, vasoconstrictors, or topical steroids and antibiotics have often already occurred before the correct diagnosis is made. Surgery treatment may be necessary in more severe cases. This may involve removing a segment of the eyelid, which tightens the eyelid.