Recognizing ectropion: an abnormality of the eyelid that folds out

Any problem or abnormality in the eyelids can dry out the eyes. In some other people, eyelid abnormalities actually cause the eyes to always water. This is because the lids act as a protection for the eyeball from exposure to foreign objects. One of the most common types of lid deformities is ectoprion, when the skin of the lid folds out, giving the eye socket a gaping appearance. To be clearer, let's look at the following discussion.

Ectropion, when the eyelid skin folds out

The eyelids are very important for maintaining eye health. The lids act as a curtain covering the cornea from exposure to foreign objects that may enter the eye.

An exposed cornea can develop epithelial defects, scarring, and even infections whose symptoms include eye irritation, pain and vision loss. The lids also help the tear ducts evenly distribute the tears over their surface to keep the eyes moist and flush out foreign objects that have already been exposed to the eye.

When the skin on the lids sags and so folds out, the condition is called an ectoprion. Ectoprione opens the inside of your eyelid and lower eye, leaving the eye prone to irritation. Ectoprions are most common in the lower lid (see following image).

source: igeorgiadou.gr

What are the causes of ectropion?

The main cause of ectropion is weakness of the muscles, tendons, or tissue around the eyelids as a result of the normal aging process that occurs as we get older. As a child and a young age, the muscles and tendons under your eyes are still tight and strong. However, gradually the strength of the muscles and tendons will weaken and stretch, causing the eyelids to sag.

Apart from aging factors, there are several triggers that can increase the risk of this eyelid disorder, such as:

• Have had trauma or injuries to the eyelids, such as surgery scars, injuries, blows, or scar tissue from burns.
• Benign or cancerous growths on the eyelids can cause the eyelids to sag and fold out.
• Genetic disorders at birth, such as Down syndrome.
• Paralysis of the face due to Bell's palsy, which can paralyze the nerves that control the facial muscles, including those of the eyelids.

What are the symptoms of ectropion?

If you have a deformity of the eyelids such as ectropion, the tears cannot flow properly into the small holes on the inside of the eyelids called punctas.

This condition will cause a variety of symptoms, such as:

• Constantly watery eyes, or even excessively dry eyes.
• The eyes become reddish due to inflammation of chronic conjunctivitis.
• Eyes stinging hot, like burning.

At first ectropion only makes the eyelids droop, then gradually they fold outward. However, in severe cases, ectropion can make the entire eyelid change. Ectropion often occurs in older adults.

What are the complications of ectropion?

Ectropion makes the cornea more irritated and prone to dryness.

If you have ectropion and experience some of the symptoms, seek medical care immediately. Without treatment, this condition can cause serious problems with the cornea. Some of the symptoms that must be treated by a doctor immediately include:

• The eyes become very sensitive to light all of a sudden.
• The eye feels very sore.
• Decreased ability to see.
• More frequent red eyes.

If it is prolonged, ectropion can cause conjuncivitis, an eye infection accompanied by pus around the eyes or on the lashes.

Other complications of untreated ectropion include:

• Corneal abrasion (scratches on the cornea or the surface of the eye)
• Corneal ulcers (lesions on the cornea or the surface of the eye)
• Visual impairment or permanent blindness

How to treat ectropion?

For mild ectropion, the doctor will provide eye drops and ointment to relieve symptoms. You may be given skin tape, is a special adhesive made for the skin, which can be used to lift and hold the eyelids so they don't fold out.

Usually, surgery will be done to repair the eyelid. However, the type of surgery is adjusted to the cause of the ectropion and the condition of the tissue around the eyelids, as reported by the Health Line:

• Ectropion due to aging, the doctor will recommend to do a lifting of the eyelid that is partially outward from the edge. Then, the muscles and tendons are tightened and the lid is sutured back together.
• Ectropion due to scar tissue will be performed with a skin graft taken from the upper lid or back of the ear. This procedure can also be performed for ectropion due to paralysis. However, it takes follow-up procedures to really improve the shape of the petals. Before surgery, you will receive a local anesthetic to make the surgery more comfortable.

After surgery you are required to wear an eye patch, apply antibiotic or steroid ointment on the eye several times during one week. In addition, the bruised and swollen part can be compressed with a towel previously dipped in cold water. At first, the lids may feel very tight after surgery. However, the condition will improve after the bruising and swelling fades.