Types of Eyelid Malposition

Eyelid malposition takes a number of forms, but all make the lids appear droopy, tired, and aged. Malposition isn’t always a cosmetic issue, though. In the case of ptosis, the upper eyelid physically droops over the eye and obstructs vision. In that case, you’ll require medical intervention to save the health of your eye.

At Arizona Ocular and Facial Plastic Surgery, Dr. Dustin Heringer treats eyelid malposition. He offers a number of effective surgeries, as well as a number of nonsurgical options. Here’s what he wants you to know about this condition.

The problems with eyelid malposition

Where your lids are located not only affects your appearance, but also affects your eyes’ health. The eyelids must be positioned properly to provide eye protection, promote proper tear production and drainage, and allow for normal blinking.

In addition to their dissatisfaction with the drooping, patients with eyelid malposition most often complain about looking tired, experiencing blurred vision, and having increased tears.

The types of eyelid malposition

There are four main types of eyelid malposition.

1. Ectropion

Ectropian comes from “ec-” meaning outer or outward, and “tropian,” meaning an abnormal deviation of the eye. An ectropion describes the condition where the lower eyelid and eyelashes turn outward because the eyelid tissue relaxes with age, but it can also occur from previous eye surgery, trauma, or facial cancer.

Because the lid deviates from its normal position, it can’t properly sweep tears into the tear duct, which leads to both excessive tearing and dryness. It also irritates the cornea, making it sensitive to light and prone to ulceration, which threatens vision.

2. Entropion

Here, the “en-” prefix means inner or inward. An entropion describes the condition where the lower eyelid and lashes turn inwards, which may be caused by the eyelid muscles relaxing with age. The lashes rub against the eye, causing excess tearing and scratching or scarring of the cornea. Sometimes there’s mucus discharge and eye crusting as a result.

3. Retraction

An eyelid retraction describes the condition where the eyelids, either upper or lower, pull away from the eye’s surface. As with entropion malpositions, it may result from eye muscle laxity. The retraction causes eye irritation, since the lids can’t properly lubricate and clean the eye’s surface.

4. Dermatochalasis

Also known as "baggy eyes," dermatochalasis describes drooping of excess skin and muscle in the upper or lower eyelid, which may cause cosmetic problems like heavy lids, bags under the eyes, and wrinkles on the eyelids, as well as medical problems such as loss of visual field. 

Dermatochalasis can also lead to irritation, ectropion, entropion, and eyelash infections of the cornea. Patients may be prone to headaches, since they have to repeatedly lift their eyebrows to see.

Treating eyelid malposition

Eyelid malpositions are treated surgically. Dr. Heringer repairs entropion, ectropion, and eyelid retraction using a simple eyelid-tightening surgery. Most patients find immediate relief of their symptoms after the procedure, and they recover quickly with minimal discomfort.

If you’re not a good candidate for surgery, the doctor might use a nonsurgical procedure to treat entropion, strategically placing sutures that turn the eyelid outward.

To treat dermatochalasis, your doctor can perform an upper or lower eyelid blepharoplasty. He removes excess skin and tissue from the eyelid, eliminating wrinkles and alleviating drooping.

If your eyes are looking tired and old beyond your years, or if they’re constantly red, gloppy, and scratchy, you need to see our experts at Arizona Ocular and Facial Plastic Surgery. To schedule a consultation, call our Scottsdale office at 480-448-0367, or book online.