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What is Ectropion?

Ectropion refers to an eye condition where an individual’s eyelid turns outward. As a result, the inner eyelid surface is exposed and susceptible to irritation. Usually, the lower lid is involved when it comes to ectropion and will often feature an element of horizontal lid laxity.

When the eyelid margin turns outward from the eye, the condition is known as ectropion. Some complications or cornea damage may result when there is no normal eye movement include tearing, corneal scarring, or even loss of vision.

Older adults are at higher risk for ectropion, and the condition usually affects the lower eyelids. In a severe situation, the entire eyelid’s length is turned outward. In milder cases, only a segment of an individual’s eyelid will droop away from the eye.

Ectropion is categorized into four (4) main types as follows;

  • Cicatricial – The shortening of the eyelid is the cause of cicatricial ectropion. The anterior lamella or eyelid comprises of the orbicularis muscle and skin. The orbicularis is the muscle around each orbit that is responsible for closing the eye.
  • Involutional – The cause of involutional ectropion is increased horizontal laxity of an individual’s lower eyelid.
  • Paralytic – The cause of paralytic ectropion is decreased orbicularis muscle tone that supports the lower eyelid.
  • Mechanical – The cause of mechanical ectropion is the displacement of the lower eyelid by a tumor.

Relief for Ectropion

Lubricating ointments and artificial tears can aid in the relief of ectropion symptoms. However, surgery is often necessary to completely correct the condition.

What are the Symptoms of Ectropion?

Usually, when you blink, the eyelids distribute tears across your eyes in an even manner, so that the eyes’ surfaces are lubricated. However, when ectropion is present, the tears will drain into tiny openings on your eyelids’ inner section called the puncta.

One of the symptoms of the condition is that an individual’s lower lid will pull away from the eyes. Also, there’s no proper drainage of tears into the puncta. As a result, an individual will experience the following signs and symptoms:

  • Watery eyes or excess tearing. When there’s absence of proper drainage, tears may gather and flow over the eyelids constantly.
  • Irritation — You can experience eyes irritation due to dryness or stagnant tears. Consequently, you will experience redness and burning sensation in both your eyelids and white part of your eyes.
  • Excessive dryness — You may experience sandy, gritty or dry feeling in your eyes when ectropion is present.
  • Light sensitivity — The surface of the cornea can become irritated from dry eyes or stagnant tears, resulting in sensitivity to light.

Possible Complications from Ectropion

Your cornea will become exposed and irritated from ectropion, making you increasingly prone to dryness. This can result in ulcers and abrasions on the cornea and may threaten your vision.

When Should You See an Oculoplastic Surgeon?

If your eyes are constantly irritated or watering or if it appears your eyelids are drooping, schedule an appointment at Wesson and Mothershed Eye Center to meet with our oculoplastic surgeon.

What are the Causes?

Primarily, the cause of ectropion is weak muscle or tissue relaxation that naturally occurs when an individual is aging. The risk of having ectropion gets higher with age. Risk factors may include:

  • Muscle weakness: The muscles underneath the eyes are prone to weakening as you age, and the stretching out of the tendon will occur. These are the tendons and muscles that support the eyelid taut against the eye. The eyelid will start drooping when these tendons and muscles become weak. For example, Bell’s palsy is a condition that destroys the nerves responsible for controlling facial muscles. This condition is a form of facial paralysis
  • Scars or earlier surgeries: When an individual’s skin is damaged as a result of trauma or burns (e.g. a severe bite) the manner in which the person’s eyelid rests against the eyes can be affected. Also, having a blepharoplasty (eyelid surgery) previously can result in ectropion, especially if the surgery removed a substantial amount of skin. Prior eye injuries or burns resulting in scarred tissue, as well as skin cancer or growths on the eyelid, also increase the risk for ectropion.
  • Facial paralysis: Some conditions, such as specific tumors or Bell’s palsy, can lead to paralysis of an individual’s facial muscles and nerves. If the paralysis affects the eyelid muscles, it could result to ectropion.
  • Genetic disorders –Ectropion is rarely congenital (present at birth), yet ectropion is often linked with down syndrome and other genetic disorders.
  • Age: Weakening muscle tissue linked to aging is the most common cause of the condition.

Treatment – Oculoplastic Surgery

Oculoplastic surgery to treat ectropion is highly effective and safe. Recurrence occasionally happens after many years, yet the vast majority are successful and permanent.

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