Ectropion is the ophthalmic disorder in which the eyelid and eyelashes pull away from the cornea, and reorient outwards.

What causes ectropion?

This ophthalmological disorder can occur for a number of reasons, hence the different types of ectropion in the eye. The most common causes are:

  • Ageing. This natural phenomenon is accompanied by the weakening of eye muscles and tendons, which affects the way the eyelids stick to the eye.
  • Genetic diseases.
  • Scars or previous operations. These can affect the way the eyelid rests against the eye.
  • Facial nerve palsies. Bell’s palsy, for example, affects the eye muscles and can lead to ectropion.
  • Cancer. Certain tumor formations can affect the eyelid, turning it outwards.

Risk factors

Patients with certain features are more likely to suffer from ectropion.

  • Contact lenses;
  • Touching the eye repeatedly;
  • Long-term administration of eye drops;
  • Old age;
  • Previous trauma;
  • Surgeries on the eye;
  • Skin disorders that also affect the eyelid;
  • Facial paralysis.

How many types of ectropion are there?

There are several types of ectropion in the eye:

  1. Senile or involutional ectropion. It occurs with ageing and is the most common.
  2. Congenital ectropion. The patient has had it since birth.
  3. Paralytic ectropion. It has to do with facial paralysis that affects the muscles of the face and causes the eyelid to turn outwards.
  4. Cicatricial ectropion. It is due to previous injury or surgery to the face. It can also occur in allergic skin reactions.
  5. Mechanical ectropion. It occurs as a result of tumors separating the eyeball from the eyelid.

What are the symptoms of ectropion?

Normally, every time we blink, tears are distributed on the surface of the eye, which cleanse, lubricate and protect the eye from injury or infection. Tears then drain into holes in the inner corners of the eyelid. In patients with ectropion of the eye, the lower eyelid pulls away from the eyeball, preventing proper tears drainage. Thus, the following signs appear:

  • Dry eyes;
  • Sensation of foreign object;
  • Photophobia (sensitivity to light);
  • Epiphora;
  • Decreased quality of vision;
  • Eye pain;
  • Redness;
  • Irritability;
  • Excessive tearing;
  • Other bacterial infections (e.g. conjunctivitis).

How is ectropion diagnosed?

Although ectropion is one of the obvious eye diseases (unlike ocular toxoplasmosis, for example), the specialist will begin the consultation by reviewing the medical history and performing an ocular examination.

The ophthalmologist uses various investigations to determine the muscle tone and tension of each eyelid to determine the cause and type of ectropion. If it is not a congenital or involutional disorder, the specialist also examines the tissues around the eyeball to determine whether the disorder has been caused by a tumor, scar, or facial paralysis.

How is ectropion treated?

In the early stages, ophthalmological treatment for ectropion consists of:

  •  Eye ointments;
  • Artificial tears (Note: if ectropion has been caused by the administration of certain types of eye drops, that treatment will be discontinued on the advice of the specialist).

Surgery for ectropion

In severe cases, surgery is required.

Specialists use different procedures to put the eyelid back in place in a physiological position, depending on the type of ectropion.

  • Senile or involutional ectropion is corrected by removing a segment of the lower eyelid.
  • Cicatricial ectropion involves the use of a skin graft to restore the anatomical plane.
  • Paralytic ectropion may also involve an upper eyelid implant in addition to lower eyelid surgery.

This operation is non-invasive, painless and performed on an outpatient basis with local anesthesia. The patient returns for control for:

  • Dressing removal;
  • Check the position of the eyelid(s);
  • Removal of sutures.

In some cases, postoperative medication – antibiotics or drops – is given to reduce inflammation and prevent infection.

When to go to the doctor?

Schedule an ophthalmological examination if:

  • You notice that one or both eyelids tend to turn outwards;
  • Your eyes are dry or, on the contrary, excessively wet.

Go immediately to the doctor if you have been diagnosed with ectropion of the eye, and you have any of the following symptoms:

  • Decreased visual acuity;
  • Severe redness of the eyes;
  • Increasing sensitivity to light.

These can indicate severe corneal damage that permanently affects vision. At Dr. Holhoș clinics, you get the best care: well-trained specialists and state-of-the-art ophthalmological technology.

Text medically reviewed by Dr. Teodor Holhoș, Ophthalmic Surgeon
Written by Dr. Holhos Team

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