Ectropion and Entropion

Functional oculoplastic surgery focuses on the eyelids, eye sockets and facial structures around the eye area. It’s a highly specialised surgical procedure combining ophthalmology and plastic surgery. The surgeries are also delicate and involve operating on incredibly fine structures.


For the eye to function effectively as a protective barrier and ensure proper lubrication, the eyelid must maintain precise positioning and movement across the eye’s surface. This intricate coordination relies on a mechanical system of muscles and ligaments, which, over time and with factors like injuries or previous surgeries, can experience wear and malpositioning.

How does ectropion present?

Ectropion, characterised by an outward-turning eyelid, presents with tearing eyes and, in advanced cases, may lead to redness and irritation along the lower lid’s lining. Severe ectropion of the lower eyelid can result in pain and potentially jeopardise eyesight due to excessive dryness.

How does entropion present?

Entropion, on the other hand, involves an inward turn of the eyelid’s edge, causing the coarse eyelashes and meibomian glands to make contact with the eye’s surface. This condition presents with pain, watering, a red eye, and an increased risk of infections and vision loss. Symptoms may develop gradually over weeks or months.

How are eyelid malpositions treated?

Identifying entropion often necessitates surgical correction, although precise application of muscle-relaxing injections in some cases can reposition the eyelid appropriately.

Eyelid malpositions stem from various causes, each of which must be specifically repaired if surgery is to be successful.

While general eye surgeons performed such eyelid surgeries in the past, it is now recognised that specialist oculoplastic teams are better suited for these procedures.

Eyelid repair surgery, whether for ectropion or entropion, is typically conducted as day case surgery, often under light sedation or local anaesthesia alone.

Experienced London oculoplastic surgeon Dr Nick Koutroumanos performs all entropion or ectropion surgeries, whether for adults or children, using scarless techniques.

Oculoplastic surgeon London


Dr Nick Koutroumanos

Dr Nick Koutroumanos is a London-based Ophthalmic & Oculoplastic surgeon, with particular subspecialty expertise in ophthalmic plastic & reconstructive eyelid, orbital and lacrimal surgery.

His private practice, based at The Hospital of St John & St Elizabeth in St John’s Wood complements his work in charge of a large NHS oculoplastics practice at the Royal Free Hospital in Hampstead.

A qualified senior trainer and Royal College Examiner in ophthalmic plastic surgery, cataract surgery and general ophthalmology, he runs an Oculoplastics Fellowship training programme that is highly sought-after by both UK and international candidates.

Kind Words from Our Patients


A true perfectionist

Words are not enough to express my sincere gratitude for the care and dedication Dr Koutroumanos put into my journey. I felt safe and secure in his hands. This is someone who truly cares about outcome and ethics of practice. A true perfectionist. I would not hesitate to wholeheartedly recommend him.

100% worth it

I had surgery a few days ago with Dr Koutroumanos for congenital ptosis. It’s early days but I don’t think it’s too early to say the results will be life changing for me in terms of confidence levels. I struggled at school due to the condition and have learnt to live with it – that is until I saw the doctor who was reassuring from the start and has just done the best job. 100% worth it and amazing to know I was in such safe hands. I can’t thank him enough.

I’m really happy with my results

I’ve recently had a brow lift and blepharoplasty with Mr N Koutroumanos. The whole process from start to finish was handled professionally and each process was very informative. I’m still at the recovery stage, so far I’m really happy with my results. Highly recommend using Mr N Koutroumanos services.