What is eyelid malposition?
Eyelid malposition is the abnormal positioning of the eyelids due to various causes.
The disorder is relatively common. As well as looking unsightly, it can lead to visual and ocular problems, which can become serious.
The most common forms are:
- Eyelid retraction: the upper eyelid is abnormally high or the lower eyelid is abnormally low.
- Ptosis: drooping of the upper eyelid.
- Entropion: the eyelid turns inwards causing the eyelashes to brush against the cornea.
- Ectropion: the lower eyelid turns outwards.
|A patient with ptosis|
What causes it?
It is usually caused by tissue relaxation due to ageing, but can also occur as a result of paralysis of the facial nerve (Bell’s palsy), trauma, scarring and surgery.
Ageing is the main cause of eyelid malformation.
How can it be prevented?
Eyelid malposition cannot be prevented, but can be treated early, if diagnosed during a routine eye examination.
- Ptosis can cause a reduction in the visual field.
- Ectropion causes poor distribution of tears over the cornea, resulting in possible irritation, a burning sensation, a feeling of grit in the eye, tearing and reddening of the eyelid and the conjunctiva.
- Entropion can produce the sensation of a foreign body in the eye, tearing, irritation of the cornea and even crusting of the eyelid and mucous secretion.
|Irritation caused by entropion|
Eyelid malposition is treated with surgery. The general aim is to reposition or anatomically and functionally reconstruct the eyelid.
Occasionally, the solution involves implanting skin grafts from patients themselves to cover areas of the eye that are left exposed as a result of retraction.
In some cases of lower eyelid malposition, IMO performs pioneering surgery called the transconjunctival midface lift. This technique avoids visible incisions, as it is performed through the conjunctiva, and consists of lifting the cheek in order for the lower eyelid to return to its normal position.
In most cases, existing surgical techniques offer an immediate solution to eyelid malposition and its associated problems.