Ectropion

Definition | Aetiology | Pathophysiology | Risk Factors | Signs and Symptoms | Investigations | Management | References

Definition

Ectropion is a condition in which part or all of the lower eyelid turns outwards away from the eye. This causes the inner surface of the eyelid to be exposed and prone to irritation.

Aetiology

Ectropion can be caused by various factors, including:

• Age-related changes, leading to muscle weakness around the eye
• Scarring from injury, burns, or infections
• Facial paralysis (e.g., Bell's palsy)
• Previous surgeries or radiation therapy
• Congenital conditions, although rare

Pathophysiology

The outward turning of the eyelid disrupts the normal function of the eyelid, including its ability to protect and lubricate the eye. This can lead to dryness, irritation, and increased risk of infection or damage to the cornea.

Risk Factors

• Age (more common in older adults)
• History of facial paralysis or neurological conditions
• Previous trauma or surgery to the eyelids
• Chronic inflammatory conditions affecting the eyelids

Signs and Symptoms

Common signs and symptoms of ectropion include:

• Outward turning of the lower eyelid
• Dryness and irritation of the eye
• Excessive tearing (epiphora)
• Redness of the conjunctiva
• Sensitivity to light
• Frequent eye infections

Investigations

• Clinical history and physical examination
• Slit-lamp examination to assess the cornea and conjunctiva
• Evaluation of eyelid function and muscle tone
• Assessment for underlying causes, such as facial nerve function tests

Management

Primary Care Management

• Lubricating eye drops and ointments: To keep the eye moist and prevent dryness
• Warm compresses: To reduce irritation and discomfort
• Referral to an ophthalmologist: For assessment and further management, especially if symptoms persist or worsen

Specialist Management

• Surgical correction: Procedures to tighten the eyelid muscles and reposition the eyelid
• Taping the eyelid: Temporary measure to protect the eye while awaiting surgery
• Management of underlying conditions: Treating any contributing factors, such as facial nerve palsy or scarring
• Regular follow-up to monitor for complications and ensure proper healing

References

1. Patient.info. (2024). Ectropion: Causes, Symptoms, and Treatment. Retrieved from Patient.info
2. NHS. (2023). Ectropion. Retrieved from NHS
3. British Medical Journal (BMJ). (2022). Ectropion: Diagnosis and Management. Retrieved from BMJ

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