Entropion and Ectropion: Eyelid Turning Inwards or Outwards
- The Straits Eye Centre
- Sep 19
- 4 min read
Introduction: When Eyelids Turn the Wrong Way
Your eyelids are more than a cosmetic feature, they protect, lubricate, and shield the eyes. But when they lose their natural position, problems arise.
Entropion happens when the eyelid turns inward, causing lashes to rub against the eye.
Ectropion occurs when the eyelid droops outward, exposing the eye surface.
Both conditions are more common in older adults and can lead to irritation, infection, and even vision-threatening damage if not treated.
What Is Entropion?
Entropion is an inward turning of the eyelid, usually the lower lid. This causes eyelashes and skin to rub against the cornea and conjunctiva, leading to:
Eye redness.
Tearing.
Foreign body sensation.
Pain and corneal damage in severe cases.
Types of Entropion
Involutional: Age-related, due to eyelid laxity.
Congenital: Rare, present from birth.
Cicatricial: Caused by scarring from injury, infection, or previous surgery.
Spastic: Temporary, due to eyelid muscle spasm.
What Is Ectropion?
Ectropion is the outward turning of the eyelid margin, usually the lower lid. This exposes the inner surface of the eyelid and leaves the eye surface unprotected. Symptoms include:
Dry, irritated eyes.
Excessive tearing (paradoxical, as tears spill out).
Sensitivity to wind and light.
Chronic redness or discharge.
Types of Ectropion
Involutional: Most common, from age-related muscle weakness.
Paralytic: Due to facial nerve palsy.
Cicatricial: From scarring or trauma.
Mechanical: Caused by eyelid tumours or heavy swelling.
Causes and Risk Factors
Aging: The leading cause of both entropion and ectropion.
Previous eye surgery or trauma.
Chronic inflammation or infection.
Neurological disease (Bell’s palsy, stroke).
Congenital anomalies (rare).
Complications if Left Untreated
For entropion: Corneal abrasions, ulcers, scarring, vision loss.
For ectropion: Chronic conjunctivitis, exposure keratitis, corneal damage.
Both conditions can significantly reduce quality of life by causing discomfort, blurred vision, and risk of eye infections.
Diagnosis in Singapore
Eye specialists diagnose entropion and ectropion with a clinical exam, checking eyelid position, tone, and eye surface health. Additional tests may include:
Fluorescein staining to detect corneal damage.
Tear film evaluation.
Treatment Options for Entropion and Ectropion
For Entropion
Temporary relief: Lubricating eye drops, taping eyelids, or botulinum toxin injections.
Surgery: Tightens or repositions eyelid muscles and tendons.
For Ectropion
Temporary relief: Artificial tears, ointments, moisture shields.
Surgery: Tightening or repositioning the eyelid. Skin grafting may be needed for cicatricial ectropion.
Both surgeries are typically outpatient procedures with local anaesthesia.
Recovery After Eyelid Surgery
Mild swelling and bruising are common for 1–2 weeks.
Cold compresses and prescribed ointments aid healing.
Patients usually resume normal activities in 1–2 weeks.
Surgery provides lasting relief, though recurrence is possible with aging.
Prevention and Eye Care Tips
Protect eyes from trauma.
Treat chronic eye infections promptly.
Regular eye exams after age 50.
Avoid rubbing eyes excessively.
Frequently Asked Questions
1. Are entropion and ectropion the same condition?
No. Entropion is inward turning, ectropion is outward turning of the eyelid.
2. Who is most at risk?
Older adults, people with previous eye surgeries or injuries, and those with facial nerve issues.
3. Can eye drops cure these conditions?
No. Drops provide temporary relief, but surgery is usually required for long-term correction.
4. Is surgery painful?
No. Procedures are done under local anaesthesia and are usually well tolerated.
5. What happens if I delay surgery?
You risk corneal damage, chronic irritation, and vision loss.
6. Is recurrence possible after surgery?
Yes, especially with further aging. However, most patients have long-lasting improvement.
7. Can children have entropion or ectropion?
Yes, but it is rare and usually congenital. Surgery is tailored to the child’s needs.
8. Are these surgeries covered by insurance in Singapore?
Yes, if they are deemed medically necessary due to vision or eye health impact. Cosmetic-only corrections are not covered.
Meet Our Specialist
At The Straits Eye Centre, your vision care is in the hands of a dedicated team of experienced ophthalmologists. Each of our doctors brings unique expertise and a shared commitment to delivering thorough, patient-focused care for all ages. Whether you need advanced cataract surgery, paediatric eye management, or treatment for complex eye conditions, our team works together to provide the same attentive care we would want for our own families.
Dr Jason Lee
Senior Consultant & Medical Director
Special interest: Oculoplastics, General Ophthalmology, Myopia, Cataract, Diabetic Retinopathy Dr Jason Lee has extensive training in eyelid, orbital, and tear system surgery, with fellowships completed in Taiwan and China. Previously a Senior Consultant at Khoo Teck Puat Hospital, he co-founded The Vision Mission, a non-profit bringing sustainable eye care to communities in Asia.
Cost, Medisave, and Insurance
Many procedures at The Straits Eye Centre are eligible for Medisave claims under MOH guidelines, and certain insurance plans may cover part or all of your treatment costs. Our patient care team will guide you through eligibility, claim limits, and paperwork, so you can focus on your recovery. For more details, refer to our Medisave & Insurance Guide.
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