Your eyelids are a very important – but often overlooked – part of your eye health. Many people live with eyelid dysfunction, which can cause a lot of discomfort and impact physical appearance. What are some common eyelid conditions, and how do Annandale ophthalmologists treat these eyelid conditions?


Ptosis is a condition that causes involuntary upper eyelid drooping. Ptosis is usually caused by issues with the muscles that lift the eyelid, the levator and muller’s muscles. This condition can be present in children (congenital ptosis) and adults (involutional ptosis). This condition often causes vision problems.

What causes Ptosis?

Children with ptosis are generally born with the condition. Kids with ptosis often lift their chin or raise their eyebrows to see better, and children with ptosis may also have other eye-related problems. Ptosis can also put children at risk for developing new eye conditions, such as amblyopia (lazy eye), crossed eyes, or astigmatism.

Adults can develop ptosis as a result of the levator muscle stretching or separating from the eyelid. This can be a side-effect of aging or can be caused by an eye injury. At Silk Vision and Surgical Center, we recommend a thorough examination to determine the root cause of ptosis and recommend appropriate treatment.

How is ptosis treated?

Ptosis can be repaired through surgery. During surgery, an eye surgeon will either tighten the levator muscle or attach the eyelid to other muscles surrounding the eye, which will help lift the eyelid. A mullerectomy may be used, which involves surgically modifying the mullers muscle and conjunctiva through the undersurface of the eyelid, avoiding skin incision. The surgery sometimes involves the removal of skin from the eyelid when appropriate.

During ptosis surgery, the doctor may use one of the several techniques to repair the drooping eyelid. An eyelid crease incision can be used to reattach or strengthen the levator muscle.  This surgery can also be done underneath the eyelid, through work on the muller’s muscle, or, by using the frontalis sling approach.


Ectropion occurs when the lower eyelid turns outward, pulling the lid away from the eye and exposing the inner lining of the eyelid. This exposes the inner eyelid and conjunctiva to air and debris. Ectropion is a condition that can vary in severity, and along with an increased risk of eye infection, ectropion can cause problems such as tearing and dry eye.

What causes ectropion?

Although ectropion is most commonly caused by muscle weakness and tissue relaxation associated with aging, other factors can trigger or cause ectropion. These factors include:

  • Eyelid scarring, which can be caused by burns, infections, injury, etc.
  • Muscle weakness or paralysis
  • Birth defects
  • Major weight loss

What treatments are available for ectropion?

If you are experiencing symptoms such as excessive tearing, burning, and irritation, or recurring pink eye, it is important to seek medical treatment. Prolonged ectropion can cause damage to the cornea.

While lubricating eye drops may be used for temporary relief, oftentimes surgery is the best medical path for ectropion treatment. Ectropion repair can be done in the office or as an outpatient procedure, meaning that in most cases, the patient is okay to return home after their procedure without an overnight hospital stay.

There are different ways to correct ectropion through surgery.   For ectropion related to muscle weakness, the doctor will make a small incision in the outer corner of the eyelid and remove a small portion of the eyelid, which allows her to tighten the muscle around the eye. The skin is then closed with dissolvable stitches. In cases where ectropion is caused by eyelid scarring, a skin graft may be necessary.


Entropion occurs when the eyelid turns inward. This causes the eyelid and lashes to rub up against the cornea. Over time, this irritation can cause extreme corneal scarring and vision loss.

What causes entropion?

Like ectropion, entropion is often caused as a result of aging. As muscles weaken, the eyelid will sometimes begin to turn inward. Other causes of entropion include:

  • Injury
  • Infection
  • Eye inflammation
  • Birth defects

How is entropion treated?

Lubricating eye drops can provide temporary relief from entropion, although surgery is often the best course of action in treating inward-facing eyelids. Like ectropion, entropion repair may also involve removal of a section of the eyelid to tighten the muscles around the eye or may require a skin graft to allow the eyelid to be repositioned.


Eyelid lesions

Eyelid lesions frequently appear as a red, brown, black or skin-colored growth on an individual’s eyelid. Eyelid lesions may be benign, a stye, or a malignant tumor – commonly skin cancer. If you notice the development of an unusual growth on or around your eye, it is important to contact a physician for examination as soon as possible.

At Silk Vision & Surgical Center, we are available to evaluate and perform in-office biopsies for our patients to determine if an eyelid tumor is benign or malignant.

If you are seeking an eyelid lesion biopsy, or are experiencing any of the eyelid conditions described above, please call our office or request an appointment with us online, and our staff will work with you to find a date and time that suits your needs.