The tight retracted lower eyelid
R. G. Small and M. Scott
Dean A. McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City 73104.
Grave's ophthalmopathy, anophthalmia, trauma, surgery, burns, and skin
disorders can result in lower eyelid retraction. The retracted lower eyelid
is tight in contrast to the lax lower eyelid of the common involutional
ectropion. Cicatrization of the skin and muscle produces the prototype
cicatricial ectropion. Downward traction on all layers of the lid rather
than cicatrization causes lower eyelid retraction. Sixty-one retracted
lower eyelids were surgically repaired without a skin graft in 40 patients.
In the new technique, the retracted lower lid is repaired by releasing the
lower eyelid retractors from their tarsal attachment. A lateral
canthoplasty and lower lid prezygomatic flap anchored to the orbital
periosteum support the released lower eyelid.
