Deformities of the Eyelids

Both entropion and ectropion are common in the elderly and a complaint of soreness and irritation in the eyes as well as watering should always prompt a careful inspection of the configuration of the eyelids. Entropion is revealed by pressing the finger down on the lower lid so that the inverted lid becomes everted again to reveal the lash line. Sometimes entropion can be intermittent and not present at the time of examination, but usually under these circumstances there is a tell-tale slight inversion of the lid, which is made apparent by comparing the two sides. Ectropion is nearly always an obvious deformity because of the easy visibility of the reddened and everted conjunctiva, but slight degrees of ectropion are less obvious. The lower punctum alone can be slightly everted, causing a watering eye, and the symptoms might be relieved by applying retropunctal cautery to the conjunctiva. Both ectropion and entropion respond well to lid surgery and there is no reason why geriatric patients should put up with the continued discomfort and irritation when a complete cure is readily available. These lid deformities can recur sometimes and require further lid surgery, but careful surgery in the first instance should largely prevent this.

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