Ectropion (ek-TROH-pee-on) is a condition in which your eyelid — typically the lower lid — turns out, leaving the inner eyelid surface exposed and prone to irritation. Ectropion occurs mainly in older adults. In severe ectropion, the entire length of the eyelid is turned out. When ectropion is less severe, only one segment of the eyelid sags away from the eye.
Artificial tears can help relieve the symptoms caused by ectropion until you can have surgery to correct the condition.
Normally when you blink, your eyelids distribute tears evenly across your eyes, keeping them lubricated. These tears drain into the little openings on the inner part of your eyelids (puncta). When you have ectropion, your lower lid pulls away from your eye and tears don't drain into the puncta properly, causing a number of signs and symptoms:
When to see a doctor
If you know that you have ectropion, be alert for symptoms of cornea exposure or ulcers, including rapidly increasing redness, pain, light sensitivity or decreasing vision. If you experience any of these vision-threatening signs and symptoms, seek immediate care in an emergency room.
Ectropion can have several different causes, including:
Certain factors increase your risk of developing ectropion:
The most serious complications associated with ectropion are irritation and damage of the cornea. Because ectropion leaves your cornea irritated and exposed, it's more susceptible to drying. This can lead to corneal abrasions and ulcers, which in turn can cause permanent loss of vision. Lubricating eyedrops and ointments can help to protect your cornea and prevent damage until your ectropion is corrected.
Preparing for your appointment
If you suspect you have ectropion, you may start by seeing your primary care doctor. However, you may then be referred to a doctor who specializes in treating eye disorders (ophthalmologist).
Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to arrive prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
Preparing a list of questions can help make the most of the time with your doctor. For ectropion, some basic questions include:
In addition to the questions that you've prepared, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
Usually, ectropion can be diagnosed with a routine eye exam and physical examination. Your doctor may pull on your eyelids during the exam, or ask you to close your eyes forcefully, in order to assess your eyelid's muscle tone and tightness.
If your ectropion is caused by a scar, tumor or previous surgery, your doctor will examine the surrounding tissue as well. Understanding how other conditions cause ectropion is important in choosing the correct treatment or surgical technique.
Treatments and drugs
Eyedrops and ointments can be used to manage symptoms and protect your cornea until a permanent treatment is done. Most cases of ectropion require surgery.
Scar tissue stretching
If your ectropion is caused by muscle and ligament relaxation due to aging, your surgeon will likely remove a small part of your lower eyelid, which tightens the tendons and muscles of the lid. You'll have a few stitches on the outside corner of your eye or just below your lower eyelid. In general, this procedure is relatively simple and will be the only surgery you need.
If you have scar tissue from an injury or previous surgery, the surgeon may 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, the outcome of surgery is less predictable, and more than one procedure may be necessary before your ectropion is completely resolved.
Following your surgery, you may need to wear an eye patch for 24 hours, and then to use an antibiotic and steroid ointment on your eye several times a day for one week. You may also use cold compresses periodically to decrease bruising and swelling, as well as acetaminophen (Tylenol, others) for pain. Avoid drugs containing aspirin, because they can increase the risk of bleeding.
At first your eyelid might feel tight, but as you heal it will become more comfortable. Most people say that their ectropion symptoms are relieved immediately after surgery. You will get your stitches removed about a week after your surgery, and you can expect the swelling and bruising to fade in about two weeks.
Although uncommon, bleeding or infection are possible risks of surgery. You will likely experience temporary swelling, and your lid tissues may be somewhat bruised after surgery.
Lifestyle and home remedies
These lifestyle tips may relieve your discomfort until you have surgery:
Last Updated: 2010-09-30
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