When the eyelid shifts to an abnormal anatomic position, this is referred to as eyelid malposition. Sixty percent of symptomatic dry eye patients have compromised lid closure due to eyelid malposition. Regardless of the type of eyelid malposition, hallmark symptoms such as foreign body sensation, excessive tearing, redness, and ocular irritation can all occur. There are distinctions between signs and symptoms. Although symptoms can help identify eyelid malposition, a careful objective examination of the eyelids is essential for determining the malposition and recommending the best treatment.