What is it?
We experience eyelid turning outward, when the rim of the eyelid does not adhere to the surface of the eyeball. The consequence of chronic eyelid ectropion is an impossible for pharmacological cure inflammation of conjunctivitis and ocular surface as well as overflowing of tear over the margin of the eyelid. Long-term eyelid eversion may even lead to degeneration of the cornea.
Causes
Causes of the eyelid ectropion may include:
· ageing of the eye tissues (involution changes) – this is the most common cause, which is due to stretching out of the so called eyelid ligaments connected with the age, sagging of the skin and tarsal plate, and reduction of the tension of orbicularis oculi;
· facial nerve paralysis;
· eyelid scarring after trauma, burns and other surgical procedures.
Also, in some cases, ectropion may be congenital.
Treatment
The method of treatment depends on the degree of turning outward of the eyelid and the state of the eyelid ligaments (their laxity). On the basis of analysis of the above factors the qualification for the surgery and decision on the method of correction of the ectropion is done.
In the case of medial ectropion including lacrimal point, which results in excessive tearing, either of the two procedures are performed: plasty of the central part of the eyelid (which consists in diamond excision of the conjunctiva) or the so-called lazy-T plasty surgery.
In the case of severe laxity of the ligaments and eversion of the entire eyelid, the lateral tarsal strip procedure is performed. It consists of dissection of a fragment of the tarsal plate and suturing it in appropriate position to the periosteum of the orbital rim. The surgery can also be performed using Kuhnt and Szymanowski procedure i.e. through reduction of the tarsal plate and plastic surgery of the eyelid removing excess skin and reducing its laxity.
After the treatment a dressing and an antibiotic ointment are applied. Skin sutures are removed after 7-10 days, and the absorbable ones are left until they self absorb.
