Nagaraju G1, Kailash P. Chhabria2, Samhitha H. R3

Lower lid malpositions form amongst the most common lid malpositions encountered in ophthalmic practice. The bilaminar structure of the eye lid is central to the understanding of the mechanism of development, identification and management of these malpositions. Lid entropion and ectropion develop due to a disparity in the functioning of the anterior and posterior lid lamellae. The previous thought of simple single procedures like inturning procedures for ectropion and out-turning procedures for entropion are no longer in vogue and should no longer be practiced. Customized Lid Surgery based on a detail clinical evaluation including special tests for various components of the malposition complex is necessary for effective management and a good surgical outcome for lid malpositions. We discuss the dynamics of the occurrence and the concepts behind the management of lower eye lid malpositions.