By Craig N. Czyz, Allan E. Wulc, Jill A. Foster

    Lower eyelid medial ectropion and medial canthal laxity present surgical challenges in the ageing eyelid. Most lower eyelid tightening procedures rely on lateral repositioning because the lacrimal drainage system interferes with access to the medial canthal tendon. This video demonstrates a basic technique – caruncular recruitment – to tighten the tendon and improve punctal aversion while preserving the lacrimal system.