Lid Malpositions

• Description: Ptosis refers to the drooping or sagging of the upper eyelid. It can affect one or both eyes.
• Causes:
  • Aging: Weakening of the muscles responsible for lifting the eyelid.
  • Congenital: Present from birth due to developmental issues with the levator muscle.
  • Trauma or Surgery: Injury or previous eye surgery affecting eyelid function.
  • Neurological Conditions: Disorders affecting the nerves that control eyelid movement, such as Horner’s syndrome or third cranial nerve palsy.
• Symptoms:
  • Obstruction of vision
  • Fatigue or strain around the eyes
  • Asymmetrical eyelid appearance

2. Ectropion (Outward Turning of the Lower Eyelid)

• Description: Ectropion occurs when the lower eyelid turns outward away from the eye, exposing the inner eyelid surface.
• Causes:
  • Aging: Weakening of the tissues and muscles around the eyelid.
  • Scar Tissue: From previous injuries or surgeries.
  • Facial Paralysis: Conditions affecting facial nerve function.
  • Congenital: Present from birth in some cases.
• Symptoms:
  • Dryness and irritation of the eye
  • Excessive tearing
  • Redness and discomfort

3. Entropion (Inward Turning of the Lower Eyelid)

• Description: Entropion is when the lower eyelid turns inward, causing the lashes to rub against the cornea.
• Causes:
  • Aging: Loss of elasticity and muscle tone in the eyelid.
  • Scarring: From injury or previous infections.
  • Congenital: Some people are born with this condition.
  • Inflammation: Chronic conjunctival or eyelid inflammation.
• Symptoms:
  • Irritation and pain from lashes rubbing against the eye
  • Redness and tearing
  • Sensitivity to light

4. Lagophthalmos (Inability to Close the Eyelids Completely)

• Description: Lagophthalmos is characterized by the incomplete closure of the eyelids, which can leave part of the eye exposed.
• Causes:
  • Facial Nerve Palsy: Impairment of the facial nerve that controls eyelid movement.
  • Trauma or Surgery: Injuries or surgical procedures affecting the eyelid or surrounding structures.
  • Thyroid Eye Disease: Conditions such as Graves’ disease that affect the eye muscles and surrounding tissues.
• Symptoms:
  • Dryness and irritation of the eye
  • Exposure keratopathy (damage to the cornea due to dryness)
  • Difficulty with sleep due to incomplete eyelid closure

5. Dermatochalasis (Excess Skin on the Eyelids)

• Description: Dermatochalasis is the condition where excess skin folds over the eyelids, often leading to a droopy appearance.
• Causes:
  • Aging: Loss of skin elasticity and increased skin laxity.
  • Genetics: Hereditary tendency towards excess skin.