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Eyelid Malpositions (Entropion/ Ectropion)

What are Eyelid Malpositions (Entropion/ Ectropion)?

  1. In addition to drooping of the upper eyelid (ptosis or dermatochalasis), the upper or lower eyelid can also turn inwards (entropion) or outwards (ectropion). These various lid malpositions can be due to a variety of factors such as laxity of the eyelid, scarring, trauma, and/or aging. 
  2. Entropion
    Entropion can be very uncomfortable for a patient as the eyelid is turned inwards causing the lashes to rub on the eye. In addition to the discomfort, this puts the patient at risk for infections of the eye. 
  3. Ectropion
    Ectropion is the eyelid turning outwards away from the eye. Although not as uncomfortable as entropion, it can still lead to eye irritation due to increased exposure of the eye or the poor blink caused by an ectropion

Entropion or ectropion repair is an outpatient procedure that can be performed in the office or in the operating room with light sedation. Correction of these eyelid malpositions is usually accomplished by tightening the loose eyelid. With entropion, an additional step may be necessary to also advance the muscle that keeps the eyelid from turning in (capsulopalpebral fascia). 


There should be minimal to no pain after the procedure. Instead, itching and tightness on the outer corner of the eyes is the most common symptom both of which resolve with time. Driving may be resumed after 3-5 days. Strenuous physical activity is resumed 10-14 days after surgery. Makeup may be used again 2 weeks after surgery. There will be mild to moderate bruising and swelling after the procedure that typically takes approximately 2 weeks to resolve; however this timeframe does depend on the patient’s health, age, medications, and adherence to postoperative instructions. In approximately 2 weeks, you should be presentable in public.


Since ectropions and entropions have the potential to compromise your eye health, insurance will cover the procedure in most cases.

You will have some bruising after the surgery that can take about 2 weeks for most of it to resolve. Itching is a common symptom after surgery due to the wounds healing. You may also notice tightness on the outer corner of your eyes as this is where the eyelid is typically tightened. These symptoms will go away with time. Most patients can drive as early as 3-5 days and make-up can be applied at about 10-14 days after the procedure. Strenuous physical activity can be resumed also at about 10-14 days after the procedure.

Fortunately the risks are fairly low with ectropion and entropion procedure. With entropion procedure, the success rate is over 90%, if not higher, with nearly immediate relief of the foreign body sensation from the eyelashes rubbing on the eye. With the ectropion procedure, the lid will be better positioned and tighter creating a stronger blink. However, patients may have other diagnoses such as dry eye syndrome that needs to be addressed for optimal outcome

Most patients will say there is minimal to no pain after the surgery. Itching and tightness sensation is the most common symptom after surgery that resolves with time