What is an ectropion?

The ectropion is when your lower eyelid turning outwards and drooping awayfrom your eye exposing the surface of your inner eyelid.

What causes the ectropion?

The main cause of the ectropion is muscle weakness or tissue relaxation that occurs as part of the normal aging process. The risk of developing ectropion increases with age.

Other factors are:

  • Stroke
  • Skin cancer
  • Injury
  • Scar tissue from injuries or burns
  • Increases in eyelid tissues (either cancerous or benign)
  • Genetic abnormalities (due to genetic disorders such as Down syndrome)
  • Bell’s palsy – which damages the nerve that controls the facial muscles – or other types of facial paralysis
  • Previous surgery or radiotherapy of the eyelids
  • Fast and significant weight loss

When you blink, your eyelids help distribute tears that protect and lubricate your eyes. Tears drain into the lacrimal puncta, which are openings inside your eyelids that lead to the nasolacrimal duct.

When the lower eyelid is turned outwards, it affects how tears flow. This can lead to a variety of symptoms, including:

  • excessive lacrimation
  • excessive dryness
  • Irritation
  • burning sensation
  • Redness
  • chronic conjunctivitis

If you have symptoms from ectropion, you need immediate medical attention. Delay in the treatment of this condition can lead to serious complications. If you experience any of the following symptoms, should be treated immediately by your doctor:

  • suddenlight sensitivity
  • eye pain
  • rapid increase in eye redness
  • decreased vision

Long-term irritation, excessive dryness and corneal exposure can lead to conjunctivitis or infection of the eye. This can lead to infected pus or fluid around the eye and on your eyelashes, especially when you wake up in the morning.

Other complications may include:

  • corneal abrasions (scratches on the cornea or on the surface of the eye)
  • corneal ulcers (wounds on the cornea or on the surface of the eye)
  • impaired vision
  • permanent vision loss

Awaiting surgical treatment, lubricating eye drops can provide relief and protect your cornea from further damage.

However,note that improper wiping of your eyes can aggravate the problem. Always wipe from the outside of your eye inwards towards the nose, using a movement “up and in”.

Skin tape can be used to lift the lower eyelid and keep it in place to relieve certain symptoms. However, be sure to first ask for instructions and recommendations from your ophthalmologist.

Most often, surgery is necessary. Surgery is usually performed under local anesthesia.

During the operation, the surgeon usually removes part of the lower eyelid. This requires stitches under the eyelid or in the outer corner of your eye. In most cases, this operation is quite effective and solves the problem.

If your ectropion is due to scar tissue or insufficient eyelid skin, you may need a skin graft (skin transplant). Your oculoplastic surgeon will take skin behind your ear or from your upper eyelid and attach it to your lower eyelid.

If you have previously had facial paralysis or multiple scars, multiple surgeries may be needed to get the best result and completely resolve the problem.

Some patients feel relief immediately and others find relief within days or a few weeks. Most patients have no other symptoms after treatment and healing.

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