Ophthalmology

Ectropion on the eye

Synonyms

Outward rotation of the lid, drooping lid of the eye

English: ectropion

definition

As with entropion, this is also a malposition of the eyelid. But not inwards here (Entropion), but to the outside (Ectropion). In addition, the lower eyelid is almost always affected with ectropion. The lid is rolled outwards and often the inside shows up, as you can only see if you pull the lower lid down with your thumb. Ectropion - like entropion - is a disease of old age.

The opposite, i.e. turning the eyelid inward, is called Entropion designated.

Symptoms

Since the lower eyelid hangs down, the tear fluid can no longer flow off in its normal way and runs over the edge of the eyelid (tears trickle). The patient wipes the tears from his cheek, pulling the eyelid downwards and thus increasing the ectropion. The chronically irritated eye is often reddened and here too it can happen that the patient feels a foreign body sensation.

The ectropion does not lead to a reduction in vision, but the conjunctiva, which is no longer protected by the lid, is easily inflammable and therefore more susceptible to infections (conjunctivitis). Often times it dries out and thickens.

Do you suffer from conjunctivitis?

Find out more about the possible therapy at: Treatment of conjunctivitis

diagnosis

The diagnosis of ectropion is easy to make because the malalignment of the eyelid is conspicuously visible. With a slit lamp (special examination device in ophthalmology) the ophthalmologist can also determine the extent of the conjunctivitis.

This article might also interest you: Home remedies for conjunctivitis

How is ectropion treated?

Surgery is usually the method of choice. An attempt is made to surgically tighten the eyelid and reattach it to the eyeball, e.g. by shortening the lower eyelid and subsequent displacement.

What is done during an operation?

In most cases, surgical treatment of the ectropion is the only way to provide long-term relief.
The procedure is similar to that of an eyelid lift.

The aim is to stop the eyelid from rotating outwards in order to adequately protect the connective and cornea again.
An eyelid lift is a very common operation.

During the procedure, the eyelid is shortened and excess fat and muscle tissue is carefully removed.
The rest is pulled apart a little and then put back onto the apple of the eye and fixed. In most cases, very thin threads are used so that no large scar remains at the end. This surgical procedure is also known as a so-called lateral rein plasty.

The procedure is usually carried out on an outpatient basis and does not require general anesthesia, just local anesthesia.
The treatment usually lasts about 1-1.5 hours.
The costs are usually around 1500-2000 €, but are partly covered by the health insurance.

What are the causes of an ectropion?

Various factors can be considered as the cause of ectropion. Most often, the ectropion is caused by insufficient muscle tension (tone) of the eye ring muscle (Orbicularis oculi muscle) causing the eyelid to roll outward and droop. Since this muscle is controlled by the facial nerve, paralysis of this nerve can also lead to ectropion (Ectropium paralyticum).

However, scars in the eyelid area that lead to shrinkage can also be the cause of an ectropion (Ectropium cicatriceum).
Furthermore, the development of an ectropion has also been observed after lid operations, e.g. for cosmetic purposes, observed.

forecast

The prognosis of ectropion is good with timely treatment. Several operations are often necessary. You should also not fail to treat any existing conjunctivitis with eye ointments.

For prophylaxis of ectropion, the patient may be advised not to wipe away tears downwards but inwards upwards.