The document discusses different types of eyelid malpositions including ptosis, ectropion, and entropion. Ectropion and entropion result from an imbalance between the forces on the anterior and posterior lamellae of the eyelid. The most common type of ectropion in practice is involutional ectropion, which is primarily caused by horizontal eyelid laxity. Involutional entropion of the lower eyelid is also common. Surgical procedures to correct ectropion include medial conjunctivoplasty and lateral canthoplasty, while procedures for entropion include transverse lid everting sutures and margin rotation by transverse tarsotomy.

1. LID MALPOSITIONSPtosis, Entropion,& EctropionDr Anupama Karanthwww.ophthalclass.blogspot.com

2. Result from imbalance between forces on anterior and posterior lamellae of the eyelidEctropion - EntropionAnterior lamella skin and orbicularisPosterior lamella tarsus and conjunctiva

3. InvolutionalEctropion and Entropion

4. Outward turning of eyelid marginTypesCongenitalInvolutionalParalyticCicatricialMechanicalEctropion

5. Most common type in practice - InvolutionalPrimary etiologic factor - Horizontal eyelid laxityClinical test - The snap testEctropion

6. Snap testTesting lid laxityThe lid does not snap back into position when pulled out and released.

7. The canthi get displaced when lower lid is pulled laterally or mediallyDisplacement of canthi

8. Ectropion – Clinical features

9. InvolutionalectropionEctropion

10. Paralytic ectropionEctropionFacial palsy

11. CicatricialectropionEctropion

12. Mechanical ectropionEctropion

13. Medial conjunctivoplasty / Medial spindle procedureEctropion surgeryLateral canthoplasty / Lateral tarsal strip procedure

14. Lazy-T procedureMedialConjunctivoplasty+Full thickness excisionEctropion surgery

15. Modified Kuhnt-SzymanowskiprocedureEctropion Surgery

16. Inversion of eyelid marginTypesCongenitalAcute spasticInvolutionalCicatricialLower lid involutionalentropion is more common Entropion

17. InvolutionalentropionEntropion

18. InvolutionalentropionEntropion

19. LacrimationRecurrent corneal erosionsCorneal vascularizationCorneal opacitiesEntropion – Clinical features

20. Transverse lid everting sutures(Quickert sutures)Entropion surgery

21. Margin rotation by transverse tarsotomy (Weis procedure)Lower lid retractor reinsertion with lateral strip procedureEntropion surgery