Ectropion (Turning out of the eyelid)
Ectropion is the most common lower eyelid malposition. It is often an ageing change resulting in eyelid laxity allowing the lid to sag away from the eye. Mild cases may not visibly turn away from the eye but can cause tearing, irritation, and/or dryness of the cornea. More severe cases will result in the eyelid truly turned away from the eye.
Symptoms may include excessive tearing, chronic irritation, redness, pain, a gritty feeling, crusting of the eyelid, mucous discharge, and in extreme cases breakdown of the cornea.
What causes Ectropion?
Ectropion most commonly results from ageing changes causing tissues to stretch and the eyelid to loosen. However, it may also occur from facial weakness (from Bell’s palsy, stroke, or other neurologic conditions), trauma, skin scarring, previous surgeries, or eyelid tumours.
What is an Entropion?
Entropion is the term used to describe rolling inward of the eyelid. Once turned in, the eyelid and eyelashes rub against the eye, usually causing significant irritation, redness, and sensitivity to light and wind. If left untreated, chronic entropion can cause corneal scarring and loss of vision. If entropion exists, it is important to have it fixed before permanent damage to the eye occurs.
What Causes Entropion?
Like ectropion, the most common cause of entropion are laxity and ageing changes. However, trauma, scarring, inflammatory conditions and eyelid tumours can also result in entropion.
What is Ptosis?
Ptosis (pronounced “toe-sis”) is the medical term for an abnormally low or droopy upper eyelid. It is different from dermatochalasis, which is the medical term for excess skin of the upper eyelid, although both are often present in the older population.
Patients often raise their eyebrows or adopt a “chin up” head position in an effort to increase their field of vision. In advanced cases, people need to lift their eyelids with their fingers to see, particularly at the end of the day. Patient often complain of heavy lids and a restriction of vision or headache due to the low upper lids blocking their field of view.
What Causes Ptosis?
The most common cause of ptosis is age related weakening or stretching of the major muscle that lifts the eyelid, the levator muscle.
It is important to be evaluated for the rare causes of ptosis including certain neurologic diseases (myasthenia gravis, cranial nerve palsy, myopathy), trauma, or congenital weakness. Ptosis may become more apparent following refractive or cataract surgery.
What is Dermatochalasis?
Dermatochalasis is the medical term for excess skin of the upper eyelid. The excess skin can, at times, hang over the eyelid margin and thereby block the pupil. Patients often raise their eyebrows in an effort to raise the drooping excess skin. In severe cases, people may need to lift their eyelids with their fingers to see. While surgery to correct mild cases of dermatochalasis is considered cosmetic, cases where a patients visual field is restricted or when the excess skin is resting on the eyelashes is considered to be non-cosmetic by Medicare.
What Causes Dermatochalasis?
The most common cause of dermatochalasis is age related weakening or stretching of the skin and deeper tissue overlying the upper eyelid.