What is Ectropion

Is a condition when the lower eyelid turns outwards. As the result the inner ‘pink part’ of the eyelid is exposed to the air and gets irritated.

 

Who can get an Ectropion of the eyelid?

Ectropion in more common in older people and can affect both men and women. Ageing of structurally weakens all tissues that add to the risk of developing ectropion.

 

What are the symptoms of ectropion?

The symptoms of ectropion are due to abnormal, prolonged and constant exposure of the eyelid and the eye. Irritation of the eye, gritty feeling, feeling of dry eye and excessive tearing are the common symptoms

 

How do I know if I have ectropion?

If you have ectropion you will experience symptoms due to irritation such as excessive tearing, and gritty feeling due to dryness. Your eyes will appear red and inflamed and the lower eyelid will be pulled down or turned outwards exposing the inner pink part of the lower eyelid.

 

Risk factors for eyelid ectropion

  • Old age
  • Significant skin ageing resulting in thinning of skin and loss of muscle tone
  • Negative Vector orbit where the under-eye cheek bone shrinks and no longer offers support
  • Scarring of the lower eyelid and tightening of the skin due to scarring.

 

What are the causes of ectropion?

There are numerous causes of ectropion.

  1. Weakness of the lower eyelid muscle leading to loss of eyelid support
  2. Facial nerve paralysis resulting in significant weakness of the lower eyelid
  3. Scarring of the lower eyelid due to previous surgery or trauma that pull the eyelid down
  4. Cancers of the lower eyelid that pull the lower eyelid downwards and cause ectropion.



Treatment of ectropion – is always surgical

  • Early treatment with lubricating eyedrops can help improve symptoms.
  • Surgical treatment involves addressing the cause.
  • Removing excess skin and muscle and tightening them
  • Tightening the tendon of the eye by a process called canthoplasty
  • If it is excessive scarring, you will need either a skin graft or a midface suspension

 

Is the Ectropion surgery done in hospital?

Yes, ectropion correction surgery is performed under Anaesthesia in hospital as a day surgery procedure

 

What should I do after the surgery?

Lubricating eyedrops to the eye every 2- 4 hours

Ice pack cold compress to reduce the swelling

Antibiotic ointment to the suture line three times a day for a week

Keep the area clean and dry

Light activities only for the first week

 

What happens at the first post operative visit?

Your first post-operative visit is scheduled for a week after surgery. The wound will be inspected to ensure it is healing well and there are no signs of infection. The sutures are removed, and you will be advised to continue antibiotic ointment for another week. The inside of the eyelid is inspected to make sure there is no evidence of chemosis, and if present appropriate steroid eyedrops are commenced.

 

What is chemosis

Chemosis is swelling of the conjunctiva (lining of the eyelid) in response to prolonged inflammation of surgery and canthoplasty. There is a definitive predisposition for post lower eyelid surgery chemosis in elderly patients who have pre-existing lower eyelid and conjunctival laxity, poor eyelid closure mechanics and pre-existing ocular surface disease. 

 

Treatment of Chemosis 

The use of eyelid lubricating drops, steroid drops together with systemic steroids and anti-inflammatory medications can help treat mild chemosis.

 

All surgery carries risk.   A second opinion from an appropriately qualified health practitioner is recommended before proceeding

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Royal Australasian College of Surgeons

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Plastic Surgery Research University of Louisville

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Royal College of Surgeons of Edinburgh

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PACES Plastic Surgery Atlanta USA