Ectropion is where the lower eyelid droops away from the eye and turns outwards, exposing the surface of your inner eyelid. It’s not usually serious, but can be uncomfortable. Ectropion mainly affects the lower eyelid and can happen in 1 or both eyes.
When the lower lid turns outward, it affects the way tears drain. This can result in a variety of symptoms, including:
• excessive tearing
• excessive dryness
• chronic conjunctivitis (inflammation also known as “pink eye”)
Ectropion can be caused by:
• Muscle weakness.
As you age, the muscles under your eyes tend to weaken, and tendons stretch out.
• Facial paralysis.
Certain conditions, such as Bell’s palsy, and certain types of tumors can paralyze facial nerves and muscles. Facial paralysis that affects eyelid muscles can lead to ectropion.
• Scars or previous surgeries.
Skin that has been damaged by burns or trauma, such as a dog bite, can affect the way that your eyelid rests against your eye.
• Eyelid growths.
Benign or cancerous growths on your eyelid can cause the lid to turn outward.
• Genetic disorders.
Rarely is ectropion present at birth (congenital). When it is, it’s usually associated with genetic disorders, such as Down syndrome.
Long-term irritation, excessive dryness, and exposure of the cornea can lead to conjunctivitis, or infection of the eye.
This can result in infected pus or fluid around your eye and on your eyelashes, especially when you wake up in the morning.
Other complications may include:
• corneal abrasions (scratches on the cornea or surface of the eye)
• corneal ulcers (sores on the cornea or surface of the eye)
• impaired vision
• permanent blindness
Ectropion can usually be diagnosed with a routine eye exam and physical. Your doctor may pull on your eyelids during the exam or ask you to close your eyes forcefully. This helps him or her assess each eyelid’s muscle tone and tightness.
If your ectropion is mild, your doctor might recommend artificial tears and ointments to ease the symptoms. Surgery is generally required to fully correct ectropion.
The type of surgery you have depends on the condition of the tissue surrounding your eyelid and on the cause of your ectropion:
• Ectropion caused by muscle and ligament relaxation due to aging.
Your surgeon will likely remove a small part of your lower eyelid at the outer edge. When the lid is stitched back together, the tendons and muscles of the lid will be tightened, causing the lid to rest properly on the eye. This procedure is generally relatively simple.
• Ectropion caused by scar tissue from injury or previous surgery.
Your surgeon might need to use a skin graft, taken from your upper eyelid or behind your ear, to help support the lower lid. If you have facial paralysis or significant scarring, you might need a second procedure to completely correct your ectropion.
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