What is Ectropion

Ectropion is drooping / laxity of lower eyelid. In these cases patients feel extremely uncomfortable with burning sensation in the eye, foreign body sensation, pooling of tears and excessive watering etc

There are 4 types of Ectropions i.e.

Involutional – Senile Ectropion affecting lower eyelid of elderly patients which causes Epiphora and in chronic cases lower lid conjunctiva is inflamed & thickened.
Cicatricial – Scarring or Contracture of skin and underlined tissues pulling the eyelid away from the globe because of trauma, burns or skin inflammation
Paralytic – It is seen in facial nerve palsy.
Mechanical – It is caused by tumors on or near the lid margin which mechanically evert the lid.

Treatment

There are multiple types of procedures that are useful to correct Ectropion which vary depending upon the type of Ectropion.

a. Senile Ectropion

In case of mild medial laxityCautery Puncture is the most appropriate and successful procedure
In severe cases excision of part of the lower lid and conjunctivoplasty are useful

b. Cicatricial Ectropion

In mild localized cases excision of the scar tissue along with skin grafting
In severe cases transposition flaps or free skin grafting is helpful

c. Paralytic

Temporary treatment for protecting the cornea in anticipation of spontaneous recovery – use of lubricant / ointment and staping
Other temporary measures are Botulinum Toxin Injection and Temporary Tarsorrhaphy
In cases of permanent damage to sixth nerve the horizontal & vertical apertures are narrowed surgically

Prognosis

Need for more than one procedure
Risks of Surgery

In case of Tarsorrhaphy and narrowing of apertures may cause decreased vision, corneal damage might not improve or may worsen in spite of the intervention

Watering of eye might not improve