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Ectropion

Ectropion is an eye condition in which the eyelid turns outward. It typically affects the lower eyelid, exposing the inner lid in either one section of eye or across the entire lid. Ectropion prevents tears from draining from the eye correctly, resulting in irritation. It usually occurs in older adults as a result of the aging process, during which muscles, tendons and connective tissue around the eyes progressively weaken. Those who have had trauma to the face or eyes are at greater risk of developing ectropion.

Causes of Ectropion

In addition to aging, there are a number of causes of ectropion:

  • Facial paralysis due to Bell's palsy or tumor
  • Facial scarring from burns or other trauma
  • Eyelid growths (malignant or benign)
  • Previous eyelid surgery (blepharoplasty)
  • Radiation of the eyelid to treat a cancerous growth
  • Excessive sun exposure
  • Rapid weight loss
  • Cosmetic laser-skin resurfacing
  • Certain eye drop medications, such as those used to treat glaucoma

In rare cases, ectropion is a congenital condition. It is usually found in infants with another genetic disorder, such as Down syndrome.

Symptoms of Ectropion

In patients with ectropion, tears do not drain properly into the small openings on the inner part of the lid (puncta). This poor drainage causes several symptoms that include the following:

  • Eye irritation and redness
  • Excessive tearing
  • Pain
  • Sensitivity to light
  • Inflammation
  • Eyes that feel dry or gritty

Patients with ectropion should be aware of its possible complications, and report any worsening of symptoms immediately.

Complications of Ectropion

Several serious complications, including the following, can result from ectropion:

  • Corneal abrasions
  • Corneal ulcers
  • Eye infections

Evidence of complications includes eye pain, sensitivity to light or rapidly increasing redness, or a decrease in vision. Any worsening of ectropion symptoms is a sign that vision is in jeopardy and emergency treatment should be sought.

Treatment of Ectropion

While there are temporary-relief treatments, such as artificial tears or soothing ointment, correction of ectropion is accomplished with a brief surgical procedure in which the eyelids are repositioned. For ectropion due to muscle weakness or scars from a previous surgery, the repair procedure may include the following:

  • Stretching of scar tissue
  • Removal of a small section of eyelid
  • Skin graft to reposition the eyelid

A patient usually needs to wear an eye patch for 24 hours after surgery. During recovery, an antibiotic and steroid ointment must be administered. Though there may be some short-term bruising or swelling after the operation, the symptoms of ectropion usually resolve immediately.

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