Eyelid malpositions

What is eyelid malposition?

Eyelid malposition is when the eyelids become abnormally positioned due to various causes. The disorder is not aesthetically-pleasing and can lead to visual and ocular problems, which can be serious.

What are the most common types of eyelid malposition?

The most common types include:

  • Eyelid retraction – where the upper eyelid is abnormally high or the lower eyelid is abnormally low.
  • Ptosis – where the upper eyelid droops.
  • Entropion – the eyelid turns inwards.
  • Ectropion – where the eyelid turns outwards.

What causes eyelid malposition?

The main cause of eyelid malposition is ageing as the tissues surrounding the eyes relax as we age. It can also occur as a result of paralysis of the facial nerve (Bell’s palsy), trauma, scarring and surgery.

What are the symptoms of eyelid malposition?

Ptosis can cause a reduction in the visual field, whilst ectropion can cause a poor distribution of tears over the cornea. This results in irritation, a burning sensation, a feeling of grit in the eye and tearing and reddening of the eyelid. Entropion can create a sensation of a foreign body in the eye, tearing, irritation, and even crusting of the eyelid.

How is eyelid malposition treated?

Eyelid malposition requires surgery to reposition or reconstruct the eyelid. In some cases of lower eyelid malposition, a surgical technique called the transconjunctival midface lift is required.

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