Correction depends on controlled tissue adjustment rather than removal of the entire eyelid margin. The surgeon removes or repositions a measured amount of redundant skin and orbicularis muscle beneath the eyelashes, then uses sutures to rotate the margin outward. This changes lash direction and eyelid position while preserving the functional tissues needed for normal eyelid movement.
The procedure targets more than the visible lash position because excess skin and underlying orbicularis muscle can contribute to inward rotation of the lower eyelid. Adjusting these tissues together supports outward rotation of the margin and helps the sutures maintain the corrected position. This combined approach is intended to reduce continued contact between lashes or lid tissue and the ocular surface.
Sutures provide mechanical support after the selected skin and muscle have been removed or repositioned. By holding the tissues in a configuration that rotates the eyelid margin outward, they help maintain a more appropriate lash direction during healing. Their role is therefore not merely to close the incision, but also to preserve the intended corrective alignment.
The surgeon makes an incision beneath the eyelashes, identifies the redundant lower-eyelid skin and orbicularis muscle, and removes or repositions a measured amount of those tissues. Sutures are then placed to rotate the eyelid margin outward and maintain the new lash direction. The sequence directly links tissue adjustment with stabilization of the corrected eyelid position.
It is considered when the malposition does not resolve spontaneously or produces clinically significant ocular symptoms. Relevant problems include persistent corneal irritation, tearing, or surface injury caused by inward-directed lashes or eyelid contact. In pediatric ophthalmology, the decision therefore centers on persistence and ocular impact rather than on the congenital finding alone.
By redirecting the eyelid margin and lashes away from the eye, treatment can reduce corneal irritation, tearing, and injury to the ocular surface. The approach also aims to preserve eyelid function while correcting the malposition. These outcomes make it useful when inward lash or lid contact is producing symptoms that are significant enough to require surgical management.