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In 2012, the Institute of Medicine recommended that a formal process be developed for the accreditation of epilepsy centers in the United States. This article provides some of the background and processes that led to the criteria by which epilepsy centers are now accredited. We describe the efficacy of lateral transorbital canthopexy using a silicone tube in managing severe paralytic ectropion. Patients with paralytic ectropion involving at least two-third of lower eyelid length and scleral exposure of 3 mm or more were considered. A si