Ectropion, Entropion, and Trichiasis

Eyelid malposition is characterized by uneven eyelids, often caused by aging, trauma, or a medical condition. Developing an eyelid malposition can go beyond being simply a cosmetic concern. Depending on the case, these conditions may eventually affect the patient’s eye and vision if left untreated. To correct an eyelid malposition, a minor surgical procedure is often required. This can typically resolve the uncomfortable symptoms that may accompany the condition, as well as prevent potential damage to the eye.

Some of the most common eyelid malposition conditions include ectropion, entropion, and trichiasis. Although each type can cause irritation, tearing, and other discomfort, proper treatment for these issues can provide permanent relief. During your appointment, one of our ophthalmologists will examine your eyes to determine what may be causing your symptoms. After a diagnosis has been made, they will recommend the most beneficial solution for your condition.


Ectropion occurs when the eyelid turns outward. This exposes the inner surface of the eyelid which can lead to irritation. It also prevents the upper and lower eyelids from properly touching, leaving the eye overly exposed. As a result, tears evaporate at a faster rate and cannot be evenly distributed over the eye. Ectropion can be uncomfortable and itchy, leading to tearing, redness, dry eye, and blurry vision. The condition typically only affects the lower eyelid.

In mild cases of ectropion, only a section of the eyelid is turned outward. For those with a more severe case, the entire length of the eyelid may be affected. This condition is most prevalent in older adults since the natural aging process can cause the tissue to relax. Ectropion can also occur from facial paralysis, trauma, and scarring.

Although artificial tears can temporarily reduce symptoms, surgery is usually required to effectively treat the condition. Our surgeons will determine the best approach based on the patient’s underlying cause. The treatment will then be discussed to help the patient understand what to expect. Most patients get relief from their symptoms immediately after treatment.


Entropion is the eyelid condition where the eyelids folds under. This causes the eyelashes and skin to rub against the eye, which tends to be very uncomfortable and cause a great deal of tearing. Entropion can also cause redness, irritation, and decreased vision. This condition can be present at all times, or only when the eyes are squeezed closed. Most patients only have entropion in their lower eyelids, and older patients are more likely to develop the condition. Entropion can also be a congenital disorder or caused by inflammation or scarring.

Regularly treating the inflammation that led to entropion may be sufficient for resolving the symptoms. If this does not alleviate the discomfort, however, a minor surgery can be performed to correct entropion, preventing the eyelid from folding under. This surgical procedure can be performed under local anesthesia, and takes about 20 minutes to complete.


Trichiasis causes the eyelashes to grow inwards, and it often occurs along with entropion. The misdirected eyelashes from chronic trichiasis can produce symptoms like redness, irritation, foreign body sensation, and tearing. This condition can result from multiple factors, such as inflammation, infection, trauma, or a congenital condition.

To improve symptoms and prevent trichiasis from reoccurring, a treatment using radiofrequency energy may be recommended, This procedure is typically sufficient for alleviating the symptoms and correcting the underlying cause. During this process, the eyelash follicles that are causing the issue are permanently removed.

If left untreated, trichiasis can cause irreversible damage to the surface of the eye, even leading to vision loss. This is why it is important to consult with an eye care professional to determine if trichiasis has developed and the best method for treating the condition.

Back to Top