Ectropion Lower Eyelid Reconstruction(Archived)

Excerpt

Ectropion is an eversion, or outward turning, of the eyelid margin leading to loss of the normal apposition of the eyelid to the globe. Ectropion may be classified as congenital, involutional, paralytic, cicatricial, or mechanical.

Involutional ectropion is caused by horizontal eyelid laxity of the medial or lateral canthal tendons. The shortening of the anterior or middle lamella can cause cicatricial ectropion. Paralytic ectropion can be caused by seventh or facial cranial nerve paralysis or palsy, resulting in loss of orbicularis oculi muscle tone. Lastly, mechanical ectropion can be caused by gravity, the mass effect of a tumor, fluid accumulation, herniated orbital fat, or poorly fitted spectacles.

The patient with ectropion may experience symptoms of corneal exposure, irritation, or epiphora due to ocular exposure, inadequate lubrication due to disruption of the tear film, and corneal disease. In addition, risks for developing ectropion are increasing age, eyelid rubbing, excessive eyelid pulling or manipulation, contact lens use, eyelid injury, skin conditions involving the lid, or previous surgery of the eyelids or orbit.

Medical management of the underlying etiology of the ectropion should be attempted before consideration of surgical correction. However, surgical ectropion repair is the only definitive management of the condition.