Specializing in Ectropion and Entropion

As fellowship-trained eyelid specialists with over 50 years of combined experience, Dr. Deborah Sherman and Dr. Mark Melson are uniquely qualified to treat ectropion and entropion. Because the eyelids are their only specialty, they have expert training and skills to perform delicate surgery on the eyelids. Dr. Sherman and Dr. Melson have extensive experience and a long track record of success with ectropion and entropion.

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What Is Eyelid Malposition?

The supporting structure of the lower eyelid may be likened to a hammock, with an inner layer of a cartilage-like element (tarsal plate) that gives the eyelid stiffness and helps the eyelid stay in proper position so it functions normally. Each end of the eyelid hammock attaches two tendons to the bone on either side of the eye. If these tendons become too loose, the eyelid may turn outward or inward. Ectropion is when the eyelid turns outward and can cause excessive tearing or dryness and irritation of the eye. Entropion is when the eyelid turns inward, which can cause the eyelashes to irritate the eye.


Ectropion occurs mainly in older adults. If the tendons become stretched due to wear-and-tear (i.e., excessive eyelid rubbing), trauma, or even other facial surgery, the lid may lose its normal position and sag outward away from the eyeball. In severe ectropion, the entire length of the eyelid is turned out. When ectropion is less severe, only one segment of the eyelid sags away from the eye.

Wind and dust may dry out and irritate the delicate tissue lining the back of the exposed lid. Tearing develops when the tear duct drain opening on the edge of the eyelid falls away from the eye and can no longer adequately drain the tears. Eventually, the eye may develop scarring, which can affect vision.


Normally, when you blink, your eyelids distribute tears evenly across your eyes, keeping them lubricated. These tears drain into the small tear drain openings on the inner part of your eyelids, called punctae. With ectropion, the lower lid pulls away from the eye, and tears don’t drain into the puncta properly, causing a number of signs and symptoms:

  • Irritation: Stagnant tears or dryness can irritate eyes, causing a burning sensation and redness in the eyelids and the whites of the eyes.
  • Excessive tearing: Without proper drainage, tears may pool and constantly flow over the eyelids. Many people with ectropion complain of watery or weepy eyes.
  • Excessive dryness: Ectropion can cause eyes to feel dry, gritty, and sandy, which increases the risk of infections.
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Ectropion Before & After Photos

Our skilled team utilizes advanced surgical techniques to correct this condition, ensuring the eyelid returns to its normal position. This procedure not only alleviates discomfort and prevents further damage but also enhances the appearance of your eye.

View Ectropion Gallery

Treatment Options

Artificial tears can help relieve the symptoms caused by ectropion until surgery to correct the condition. Ectropion surgery is designed to tighten the stretched tendons in order to reposition the eyelid in its normal position. However, in some patients, additional tissues may be used to provide a new means of support so that the eyelid is positioned properly and performs its function.

When to See a Doctor

If you know that you have ectropion, be alert for symptoms of cornea exposure or ulcers, including rapidly increasing redness, pain, light sensitivity, or decreasing vision. If you experience any of these vision-threatening signs and symptoms, seek immediate eye care with a trained professional in eye care, such as your ophthalmologist, optometrist, or ophthalmic plastic surgeon.

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Like ectropion, entropion develops from a weakening of the eyelid support system. As we age, our eyelid tendons may loosen, similar to the elastic becoming loose in the waistband of pants, causing the eyelid to become lax and floppy. When the eyelid tendon band loses its elasticity, the horizontal laxity increases such that the eyelid may turn inward, causing the eyelashes to rub and scratch the front surface of the eye, which is painful and increases the risk of serious corneal infections. Pain from the lashes and skin rubbing against the cornea can be severe, and the risk of damage to vision is immediate.

Entropion Before & After Photos

Our experienced team employs advanced surgical techniques to correct the inward turning of the eyelid, restoring it to its natural position. This procedure not only alleviates symptoms but also protects your eye health and enhances your comfort.

View Entropion Gallery

Treatment Options

Surgical correction for entropion entails rotating the lid margin back to a more normal position by tightening both the canthal tendons and the tendon-like sheath. Rarely, entropion affects the upper eyelid; in this situation, grafting of tissue from donor sources is generally required.

Why Choose Sherman Aesthetic Center?

Drs. Sherman and Melson bring over 50 years of combined expertise to eyelid surgery and facial aesthetics, delivering personalized and VIP-level care. Our treatments focus on revitalizing and improving the natural appearance and function of eyelids facing concerns like drooping or misalignment. We prioritize one-on-one attention, employing the latest surgical and injectable techniques for facial rejuvenation. All our providers undergo extensive training, continually honing their skills through additional courses. At Sherman Aesthetic Center, we take pride in offering cutting-edge surgical and non-surgical solutions, ensuring our patients benefit from the most advanced and innovative care in the field.

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