Find out what is involved in repairing droopy lower eyelids using a lateral tarsal strip surgery technique

A very common issue that develops as we age is the loosening or sagging of the lower eyelids. This results in the gradual downward sagging of the eyelids which can then lead to reduced eyelid coverage of the eye itself. 

In some more extreme cases the eyelid even flips forward. The medical term for this downward eyelid sagging is ectropion.

Among the issues that ectropion can cause is chronic dry eyes and tearing as the lids don't do their job of covering the lower aspect of the eye as well. Additionally, the windshield wiper action of the lids is less efficient as tears often pool in the gap between the lid and eye. 

Lower Lid Ectropion Example Photos

Here are some good examples of patients with lower eyelid ectropion

You can see how in all of these patients there is a lot more of the whites of the eyes visible below their irises.

How To Fix Ectropion?

An elegant approach to fixing this lower lid sagging is what is called a lateral tarsal strip procedure. This inovolves shortening and tightening the lower tendon. You can think of this as akin to tightening a slack clothesline.

The surgery involves placing an incision at the corner of the eye (in the crow's foot area) like this:

Next, the lower eyelid tendon in the area is isolated, shortened and anchored to the inner portion of the eye socket bone with a stitch.

The result is a tighter, less saggy lid.

The outer skin incision is closed with additional sutures and typically heals very well.

Lateral Tarsal Strip Surgery Before and After Result Photos

You can see some after results of lateral tarsal strip surgery here:

This patient had only her left lid sagging treated (since she wasn't having right eye symptoms):

In all of these patient you can see how the treated eyelids have much better position and a well-healed, very difficult to see outer scar.