Abstract
Background and Aim
Involutional lower eyelid malpositions, such as ectropion and entropion, are frequently
encountered in oculoplastic clinics, particularly among elderly patients. These conditions
result from age-related weakening of the eyelid structures, leading to eyelid eversion
(ectropion) or inversion (entropion). Similarly, lagophthalmos, often caused by facial
nerve dysfunction or mechanical factors, presents with incomplete eyelid closure.
Aim of this article is to propose a clinical grading and a grade based management
algorithm for lower eyelid malpositions.
Clinical Presentation
Patients with ectropion may experience tearing, irritation, and conjunctival exposure,
while those with entropion often present with foreign body sensation, redness, and
corneal damage. Lagophthalmos typically manifests as dryness, exposure keratopathy,
and nocturnal eye discomfort.
Purpose and Approach
This article proposes a structured, graded algorithm to guide the management of these
conditions, offering a systematic, stepwise approach tailored to the severity of eyelid
malposition.
Algorithm and Treatment Options
The algorithms are designed to simplify clinical decision-making by categorizing ectropion,
entropion, and lagophthalmos into distinct grades, each with corresponding treatment
options. These include both conventional surgical techniques and innovative approaches,
allowing for individualized care that addresses both functional and aesthetic concerns.
Outcomes and Benefits
The goal of this graded approach is to optimize patient outcomes, reduce recurrence,
and enhance the precision of surgical interventions.
Conclusion
By providing a comprehensive framework for managing these complex eyelid disorders,
this algorithm serves as an essential tool for ophthalmologists in clinical practice.
Keywords
ectropion - entropion - lagophthalmos - graded algorithm - lower eyelid malposition
