Ectropion
What is Ectropion?
Ectropion is the out-turning of the lower eyelid and is a very common condition in Australia.
Who is at risk of Ectropion?
- Older age – ectropion is most commonly caused by laxity of the lower eyelid (due to ageing and gravity), allowing the eyelid to flop outwards.
- Sun light exposure - Often there is tightness in the eyelid skin (e.g. due to sun light damage over many decades) which contributes to pulling the eyelid out.
- Other causes include facial muscle weakness such as Bell’s palsy, or previous eyelid/facial surgery resulting in scars which pulls tight and turn the eyelid outwards.
What are the symptoms of Ectropion?
The inside of the eyelid is lined with conjunctiva and is normally moist. When it is pulled away from the eyeball, it is exposed to the dry air. This causes eye irritation and foreign body sensation. The eyelid becomes inflamed and red. The eye produces extra tears and mucus resulting in watering and stickiness. Along the edge of the eyelid closest to the nose, there is a small hole (the punctum) that drains tears. In ectropion, the punctum is pulled away from the eyeball, resulting in an overflow of tears.
How is Ectropion diagnosed?
When ectropion is significant, this is easily visible. Careful examination of the eyelid and face is required to exclude other causes, and to plan for the appropriate treatment.
How is Ectropion treated?
If the ectropion is mild, this can be managed conservatively with frequent lubrication such as eyedrops or gel. If this is insufficient to improve symptoms or the ectropion is significant, then eyelid surgery will be required to tighten the eyelid and turn it back to the normal position. Depending on the tightness of the eyelid skin, it may be necessary to borrow some skin from the upper eyelid and suture this into the lower eyelid (a skin graft) in order for the eyelid to return to its natural position. The eyelid usually heals very well with minimal scars to be seen after healing.
What if Ectropion is not treated?
If untreated, ectropion will continue to cause discomfort and may lead to an increased risk of eye infections or problems with the cornea due to exposure to the dry environment. It may remain stable or worsen with time and is uncommon for it to improve without treatment.
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