The eyelids perform important functions, such as keeping debris from the eyes and spreading the tear film across the ocular surface. When the eyelid is injured or malpositioned, problems can arise. Ectropion, the outward turn of the lower eyelid, is a relatively common problem that can be solved by consulting with an ophthalmologist.
What is Ectropion of the Eye?
Ectropion is the term used to describe a lower eyelid that turns outward. This turning may cause the inner lining of the eyelid to be visible. Because the eyelid does not come into contact with the eyeball as it should, ectropion can cause symptoms such as a burning sensation, dry eyes, excessive tearing, and chronic eye infections.
Several factors may cause the lower eyelid to turn outward. In some cases, the problem is present at birth (congenital). It can also be acquired, occurring later in life. This is more common, and may involve:
- Involutional ectropion is an age-related condition and may be the most common type of lower eyelid ectropion to occur. It is believed that the lower eyelid may droop outward due to the loss of strength in the elastic fibers and collagen protein in the eyelid. Without adequate collagen and elastin, the skin and connective tissue loosen. Loosened eyelid skin can result in an outward fall due to gravity.
- Cicatricial ectropion is a less common condition that results from abnormal contractions of the lower eyelid. Abnormal contractions could be caused by scar tissue in the lower eyelid.
- Paralytic ectropion may stem from a nerve problem. For example, a facial nerve that operates the lower eyelid could be damaged during a stroke. Usually, cranial nerve paralysis causes other problems in facial movement, as well.
- Mechanical ectropion is an outward turn that occurs when a mass or tumor pulls the lower eyelid downward.
An eyelid that turns outward can be repaired with a minor surgical procedure. Depending on the severity of ectropion, a doctor may first prescribe drops to keep the eyes lubricated and comfortable. In the case of scar tissue, it may be advisable to perform controlled stretching of the dense, rigid skin. Ectropion surgery is an outpatient procedure that is often performed with local anesthesia, eliminating the risks of general anesthesia. This operation may involve small incisions and the removal of part of the lower eyelid to restore contact with the eyeball. Stitches are placed discretely at the outside corner of the eye.