Ectropion - An overview | Capsule Health

Contents

Cover image: Lower lid laxity with more inferior scleral show on the left compared to the right eye.

Out-rolling of the lid margin.

Classification

Congenital ectropion
Involutional ectropion
- Commonest
- Only lower lids
- Due to age-related changes:
  - Horizontal laxity of eyelid
  - Medial canthal tendon laxity
  - Lateral canthal tendon laxity
  - Disinsertion of lower lid retractors
Cicatricial ectropion
- Cause: Thermal & chemical burns, lacerating injuries, skin ulcers
Paralytic ectropion
- Paralysis of VIIth nerve
- Cause: Bell’s palsy, head injury, infection of middle ear, operations on the parotid gland
Mechanical ectropion
- Tumour
- Proptosis & marked chemosis of conjunctiva

Lid margin out-rolled
1. Grade I: Only punctum everted
2. Grade II: Lid margin everted, palpebral conjunctiva visible
3. Grade III: Fornix visible
Etiological changes:
- Cicatricial ectropion: Skin scars
- Paralytic ectropion: CN-VII palsy
- Involutional ectropion:
  - Horizontal lid laxity
  - Medial canthal tendon laxity
  - Lateral canthal tendon laxity

Complications:

Dryness and thickening of conjunctiva and corneal ulceration (exposure keratitis)
Eczema and dermatitis

CONGENITAL ECTROPION
- Horizontal lid tightening
- Full thickness skin graft
INVOLUTIONAL ECTROPION
- Medial conjunctivoplasty
- Horizontal lid shortening
- Bryon Smith’s modified Kuhnt-Szymanowski operation
- Lateral tarsal strip technique
PARALYTIC ECTROPION
- Temporary measures
  - Topical lubricants
  - Taping temporal side of eyelid
  - Suture tarsorrhaphy
- Permanent measures
  - Horizontal lid tightening
  - Palpebral sling operation
CICATRICIAL ECTROPION
1. V-Y Operation
2. Z-plasty
3. Excision of scar tissue and full tissue grafting
MECHANICAL ECTROPION
- Treating underlying mechanical force

Further reading

Involutional ectropion (2015) Available at: http://webeye.ophth.uiowa.edu/eyeforum/cases/218-ectropion.htm (Accessed: 10 December 2016).