Vision Scotland : Everything you need to know

Ectropion and Entropion

Oculoplastic surgery or oculoplastics is an umbrella term for surgical treatments on or around the eye, for medical or cosmetic reasons.
Mr Sanjay Mantray, Consultant Ophthalmologist at Vision Scotland

Correcting Ectropion or Entropion Eyelids

Ectropion and Entropion eyelids occur when the skin and muscles around the eyelid loosen. The result is that the eyelid can turn outwards (Ectropion) away from the eye, or inwards (Entropion) rolling into the eye. Both cause irritation and soreness, prompting the eye to water heavily. Either can be corrected with surgery.

What is an Ectropion eyelid?

An ectropion eyelid can affect one eye or both and is where either part or all of the lower eyelid turns outwards from the eye. This can cause the inner lining of the eyelid to become sore, irritated, and watery. Damage can also be done to the cornea if the eye isn’t able to close properly.
There are many causes of this condition but the most common is ageing. The condition is not usually serious but does cause some discomfort. Apart from affecting how the eye looks, the drooping eyelid may also disrupt the drainage of tears, adding to the irritation.
meet the vision scotland team
Mr Jonathan Ross looking down a microscope during cataract surgery

What is an Entropion eyelid?

An entropion eyelid occurs when the eyelid rolls inwards. Typically, it affects the lower eyelid but it can also affect the upper lid. The main symptom of entropion eyelid is a discomfort caused by irritation from the eyelashes. This is because the inward roll of the eyelid results in the eyelashes rubbing against the eye.

The condition can be present from birth but is more commonly infection or age-related. Severe entropion can be quite painful and can cause damage to the cornea due to the irritation, occasionally resulting in vision loss. Eye drops can prevent the eye from becoming dry and may relieve symptoms, but surgery is usually required to permanently correct the condition.

Vision Scotland : Eye care specialists

Correction with surgery


Surgery is usually required to correct the effects of ectropion/entropion eyelids, and the best results are obtained if the condition has not become too severe. The operation ‘tightens’ the skin and muscles around the eyelid, which should be sufficient to correct the problem if caught early, or a second operation may be required for severe cases.

Surgery time

This is a relatively small operation and requires being in hospital for 3-4 hours, and a 30-minute operation, usually performed while you are awake. Local anaesthetic is gently used to numb the treated area.


After surgery, you will have some bruising and swelling and will be asked to apply antibiotic cream to the treated area for 1 – 2 weeks depending on prescription.

Beyond this, we encourage you to use a moisturiser to the healing skin for three months in order to achieve the best results. Bruising and swelling can be minimised with regular cold-compress packs, arnica cream and tablets, and sleeping more upright with extra pillows for the first few days. A short course of ibuprofen may also reduce swelling and discomfort.


If you are taking aspirin or warfarin or any other blood-thinning agent it is quite important that you continue to take it, but please discuss this with your surgeon at your first appointment.

Make an appointment to discuss Ectropion or Entropion eyelid surgery.