An ectropion is a misalignment of the eyelid that can have various causes. An eyelid protrudes so that it no longer rests on the eyeball. This leads to various complications, including corneal injuries, redness and inflammation.
Below you will find further information and selected ectropion specialists.
With advancing age, muscles and the elasticity of the skin slacken. In some people, the lower eyelid therefore begins to droop. Many cases of ectropion are therefore age-related. This is referred to as ectropion senile.
Other causes of ectropion are
Age-related ectropion occurs exclusively on the lower eyelid. The other forms of ectropion can also occur on the upper eyelid.
An ectropion can cause various complications. You should therefore consult an ophthalmologist at an early stage and discuss possible treatments with them.
As the eyelid is turned outwards and droops, the eyelid edge function is restricted. The cornea and conjunctiva are no longer sufficiently moisturized and dry out quickly. As a result, the conjunctiva is regularly reddened and irritated.
In many cases, chronic conjunctivitis develops, which is characterized by the following symptoms:
In an ectropion, the eyelid is no longer attached to the eyeball © arztsamui | AdobeStock
A cornea that is permanently too dry can also become inflamed. This can lead to damage to the corneal epithelium(corneal erosion) and corneal inflammation(keratoconjunctivitis). Signs of corneal inflammation are
The cornea can be injured due to dehydration. This increases the risk of a bacterial infection. This can lead to the development of a corneal ulcer.
Tear troughs are located on the upper side of the eyelid edges on the nasal side. These are small openings in the edge of the eyelid through which tear fluid drains into the nasopharynx. Tear fluid is not only produced when we cry, but the body produces it continuously. This keeps the eyes moist.
In the case of ectropion, the eyelids and therefore the tear ducts no longer lie directly on the eyeball. As a result, the tear fluid runs down the cheek and the eye tears continuously(epiphora).
Those affected frequently wipe their hands over the affected eye. The frequent wiping movements can in turn lead to infections with
lead to infections with bacteria, viruses or fungi.
The doctor usually diagnoses an ectropion based on the characteristic eyelid malposition. The examinations that follow the visual inspection are primarily used to determine the extent of the ectropion and its accompanying symptoms.
The doctor uses a slit lamp to check the inner eyelid angle and the position of the lacrimal puncta. The ophthalmologist also uses the slit lamp to examine the cornea. This allows him to check whether there is conjunctivitis or irritation of the cornea.
He also determines the eyelid tension and establishes the extent to which the conjunctiva of the affected eye is irritated.
Depending on the underlying trigger, further tests may be necessary. If a paralytic ectropion is suspected, further examinations of the facial nerve supplying the eye may be necessary.
The individual treatment measures depend largely on the underlying cause of the eyelid malposition.
Eye therapies such as ointments or gel-like moisturizers and tear substitutes can alleviate the symptoms in the short term. They also prevent complications such as inflammation. However, they do not treat the misalignment itself, only the symptoms.
To permanently eliminate an ectropion, an operation is necessary as part of eyelid surgery. This also applies to mild forms of ectropion. During the procedure, the surgeon reattaches the edge of the eyelid to the eyeball.
In the case of age-related ectropion, an eyelid lift is usually performed to correct the eyelid malposition (lateral palpebroplasty or tarsal palpebroplasty). This
the surgeon shortens, tightens and fixes the affected eyelid using various incision techniques so that it lies on the eyeball again.
In the case of paralytic ectropion, an eyelid lift is not necessary if the underlying facial paralysis recedes. In this case, the doctors wait and see. The patient should keep the affected eye moisturized with ointments or gels.
A so-called watch glass bandage over the eye can also help. A watch glass bandage is a plaster bandage with a viewing window in the middle. This protects the eye from drying out by creating a moist chamber and thus ensuring that the eye is sufficiently moisturized. Before applying the bandage, you can also apply
before applying the dressing.
A watch glass bandage keeps the eye moist © Andrea Kamphuis | Wikimedia / License
The facial paralysis usually regresses within six weeks to six months. This often also improves the ectropion.
However, if the facial paralysis persists, surgery is also required to reduce the eyelid gap. In addition to an eyelid lift, a so-called tarsorrhaphy is used to close the palpebral fissure. In this procedure, the surgeon places a suture between the upper and lower eyelid to partially close the palpebral fissure.
Ectropion has a good prognosis if treatment is started early. Depending on the cause, they usually heal without causing consequential damage. You should allow about 14 days for regeneration after the operation. During this time, you should refrain from going to the sauna and sunbathing.
Without treatment, the outward rotation of the eyelid causes increasingly severe discomfort. It can lead to chronic conjunctivitis and eventually to corneal inflammation. This in turn can lead to permanent corneal damage if left untreated. This is accompanied by severely impaired vision and even blindness.
To prevent ectropion, you should always have inflammation in the eye area treated at an early stage. Especially if the conjunctiva or eyelid edges are affected.
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