Ectropion is a medical condition commonly seen in an oculoplastics clinic, in which the lower lid margin everts – rolls away- from the eyeball. Patients with ectropion experience constant eye irritation, tearing, and foreign body sensation. Both eyes may be affected at the same time, depending on the cause of ectropion.
The four leading causes of ectropion
There are four main reasons why a lower eyelid may become ectropic:
Involutional ectropion. Also known as senile ectropion, it is caused by severe laxity of the lateral canthal tendons secondary to the aging of the eyelid tissues. This is the most common type of ectropion. Treatment consists of surgically tightening the tendon through a lateral tarsal strip procedure, also known as canthoplasty.
Cicatricial ectropion. The second most frequent type, cicatricial ectropion, occurs when there is a skin shortage in the lower eyelids due to surgery, such as blepharoplasty, or chronic sun damage to lower eyelid and cheek skin. It may also occur after trauma or facial skin burns. Treatment consists of either skin grafts on the lower lids or a midface lift.
Paralytic ectropion. This is commonly seen in patients with facial paralysis or Bell’s palsy. It is caused by poor orbicularis muscle function. This muscle is responsible for blinking and providing support to the eyelid; therefore, motor paralysis causes the lower lid to become weak and droop (ectropion).
Mechanical ectropion. This is a rare cause of ectropion. The term is used for lower eyelid displacement secondary to a mechanical pull by a mass. The weight of the mass, which may be benign or cancerous, coupled with moderate eyelid laxity, will cause the lid to sag under its weight, thus becoming ectropic.
|