Lower Eyelid

Dr. Walrath treats lower eyelid malposition with a variety of procedures:

Ectropion repair: Repair the out-turned lower eyelid, improving tearing and poor appearance.  Occasionally, there is a need for more advanced techniques, including:

• With posterior eyelid spacer implants: implants inside the eyelid that provide extra height for the eyelid, especially in patients with prominent eyes (a cheek lift may be of great importance in maintaining proper eyelid position in these patients)
• With full-thickness skin grafts: to overcome a shortage of skin, often after repair of eyelid trauma or cosmetic surgery or laser / chemical scarring of the lower eyelid
• With tear drain rotation: for tearing due to improper position of the tear drain that opens onto the eyelid margin

Below is an example of an ectropion with medial lid laxity that will require lid tightening and inturning of the tear drain opening on the eyelid.

Entropion repair: repair the inturned lower eyelid, protecting the ocular surface. Usually this involves tightening the eyelid horizontally, and also tightening the inner layers of the eyelid vertically. Occasionally, more specialized methods are required, including:

• Mucous membrane grafting: using lining of the lip to resurface the inside of the eyelid, to release scarring and inward pulling on the eyelid

A standard case of age-related entropion is pictured below: