Ectropion and entropion are two of the most critical functional disorders of the lower eyelid, and correcting them requires an in-depth understanding of eyelid dynamics and high-precision surgical technique. At Clínica Ramírez & Gálvez, we treat these conditions not merely as a cosmetic problem, but as a real threat to the integrity of the ocular surface. An accurate diagnosis of whether we are dealing with ectropion or entropion is vital to avoid serious complications such as exposure keratopathy or persistent corneal ulcers that could irreversibly compromise vision.
Pathophysiology of eyelid malpositions 🔬
Ectropion and entropion are usually linked to age-related (involutional) laxity of the tissues, although they can also have cicatricial (scarring) or paralytic causes. In both cases, the balance between the canthal tendons and the eyelid retractor muscles is lost.
- Ectropion: The edge of the eyelid everts (turns outwards), leaving the tarsal conjunctiva exposed. This causes extreme dryness and constant watering (epiphora), as tears cannot drain properly through the lacrimal puncta.
- Entropion: The eyelid inverts (turns inwards), causing the eyelashes to rub constantly against the cornea (trichiasis). This mechanical friction is extremely painful and is the main cause of recurrent corneal erosions.
Advanced surgical approach: the lateral tarsal strip 🎯
To correct both ectropion and entropion, the technique of choice at our clinics in Lucena and Torre del Mar is the “lateral tarsal strip”. This procedure involves shortening the eyelid and re-anchoring it to the lateral orbital rim, restoring its tension and correct anatomical position.
However, the surgical treatment of ectropion and entropion involves some important differences:
- In ectropion, as well as tightening the eyelid, it is sometimes necessary to verticalise the eyelid or use skin grafts if there is a cicatricial component.
- In entropion, it is essential to act on the eyelid retractor muscles to stop them from continuing to exert the force that turns the eyelid margin inwards towards the eyeball.
CO2 laser technology is a key ally in these operations. By allowing clean dissection and complete control of bleeding (haemostasis), Dr Ramírez can precisely identify the lax anatomical structures, ensuring that the anchoring is stable and long-lasting. This minimises the risk of recurrence, which is very common when ectropion and entropion are not treated with the necessary surgical rigour.
Medical rigour and technology in the operating theatre 🏥
Correction of ectropion and entropion is carried out as an outpatient procedure under local anaesthesia and sedation, in an environment of maximum surgical safety. The use of high-resolution microscopy is non-negotiable in our practice; only in this way is it possible to handle sutures finer than a human hair, ensuring that scars are virtually imperceptible after recovery.
At Clínica Ramírez & Gálvez, we understand that every patient with ectropion or entropion has a different degree of laxity and tissue quality. That is why we do not apply standardised techniques; instead, we personalise the tension vector in each eyelid to restore the protective function of the tear film and visual comfort.
The health of the ocular surface depends directly on the position of the eyelids. If you suffer from chronic watering, irritation or notice that the shape of your eyelid has changed, a specialist assessment is essential to prevent further damage to the cornea. At our clinic, we apply all our surgical expertise and technological innovation to restore the eye health you need. We will be delighted to welcome you to our facilities for a thorough diagnosis of your case and to explain how we can help you restore the wellbeing of your eyes.