Ectropion Symptoms, Causes & More
Article Sources
- 1. 'Ectropion.' Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html.
- 2. 'Ectropion.' Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/symptoms-causes/syc-20351164.
- 3. NHS Choices, NHS, www.nhs.uk/conditions/ectropion/.
- 4. Entropion and Ectropion By James Garrity, et al. 'Entropion and Ectropion - Eye Disorders.' Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/eye-disorders/eyelid-and-tearing-disorders/entropion-and-ectropion.
- 5. 'Ectropion.' Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/diagnosis-treatment/drc-20351169.
Eyelids help protect the eyes from irritation and infection by keeping the surface of the eye lubricated with tears. Normally, the upper and lower eyelids close together, completely covering the outer part of the eye. Sometimes, however, one of the lids turns outward, preventing the eyelids from closing correctly. This is called ectropion, and it may be congenital or acquired.
Usually, ectropion occurs on the lower eyelid, affecting one or both eyelids.1‘Ectropion.’ Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html. Sometimes, the entire length of the eyelid turns outward, but in less severe cases, only part of the eyelid droops away from the eye.2‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/symptoms-causes/syc-20351164. There are different types of ectropion.
1. Ectropion Symptoms
When ectropion affects one or both eyes, tears are unable to drain properly. This may cause watery eyes, as the tears flow uncontrolled over the lower lids. The eyes may burn and feel dry, gritty and irritated, and the eyelids and whites of the eyes may appear red.2‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/symptoms-causes/syc-20351164.
The eyelids may not be able to close completely. Vision may be blurry, the eyes may be sensitive to light and they may be painful.1‘Ectropion.’ Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html. Bacterial infections, such as conjunctivitis, are also more likely to develop, and the person may feel as if a foreign body is in the eye.3NHS Choices, NHS, www.nhs.uk/conditions/ectropion/.,4Entropion and Ectropion By James Garrity, et al. ‘Entropion and Ectropion - Eye Disorders.’ Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/eye-disorders/eyelid-and-tearing-disorders/entropion-and-ectropion.
2. Involutional and Paralytic Ectropions
Involutional ectropion is the most common acquired ectropion. It occurs when the collagen and elastic fibers in the eyelid weaken, making the eyelid more likely to droop due to gravity. This ectropion often occurs in older people.1‘Ectropion.’ Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html.
A paralytic ectropion develops due to problems with facial nerves. If the nerves are affected by a stroke or Bell's palsy or if facial paralysis occurs, ectropion may result.1‘Ectropion.’ Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html.,2‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/symptoms-causes/syc-20351164.
3. Cicatricial and Mechanical Ectropions
Scarring that causes the lower eyelid to contract abnormally may cause a cicatricial ectropion. Common causes of scars that can lead to this type of ectropion include eye injuries, such as burns and animal bites. Eye infections and complications following eye surgery may also lead to cicatricial ectropion.
If a growth develops on the eyelid, it may pull the eyelid down, causing a mechanical ectropion. This may occur if the abnormal growth is benign or cancerous.1‘Ectropion.’ Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html.,2‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/symptoms-causes/syc-20351164.
4. Risk Factors
Aging is the most common risk factor when it comes to the development of ectropion since the muscle tissue in the eye grows weaker over time. Genetic abnormalities, such as Down syndrome, may also make ectropion more likely to occur.
Other risk factors for ectropion include facial trauma, burns and cancer. People who have had surgery on their eyelids are also more prone to developing ectropion. The more skin previously removed from the eyelid, the likelier it is that ectropion occurs.2‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/symptoms-causes/syc-20351164.
5. Complications
As the eye experiences excessive dryness as a result of ectropion, it's more likely for abrasions and infections to affect the cornea of the eye. These can lead to ulcers that cause scarring, ultimately resulting in possible vision loss.
Blurred vision, severe eye pain, increased eye redness and light sensitivity are symptoms that require immediate medical attention. Associated symptoms indicating possible corneal damage or infection include eyelid swelling and discharge from the eye.1‘Ectropion.’ Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html.
6. Diagnosis
To diagnose ectropion, a health care provider begins by reviewing the person's medical history. Then, they conduct a physical examination of the eye and the surrounding area. To evaluate muscle tone, the provider may tug gently on the eyelids and ask the person to blink forcefully.
No imaging tests are necessary. The physical inspection provides all the information the provider needs to make a diagnosis and suggest a treatment plan.5‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/diagnosis-treatment/drc-20351169.
7. Home Care
Lifestyle adjustments may help alleviate symptoms of ectropion. While people with ectropion may need to wipe their watery eyes frequently, they may minimize excessive stretching of the muscles and skin on and around the eyelids by wiping from the outer corner of the lid toward the inner corner.
Using artificial tears can help keep the eyes lubricated, preventing damage to the cornea. Using a moisture shield on the affected eye while sleeping may also be helpful.5‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/diagnosis-treatment/drc-20351169.
8. Non-Surgical Treatment
The severity of the ectropion dictates the treatment plan. In mild cases, no treatment may be necessary and the person may benefit from using the home care suggestions listed above.3NHS Choices, NHS, www.nhs.uk/conditions/ectropion/.
The health care provider may also prescribe lubricating eye drops and steroid ointments to help alleviate some of the symptoms. If an infection is present, they may prescribe antibiotics. In addition, they may suggest taping the eyelid into place, particularly at night.1‘Ectropion.’ Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/e/ectropion.html.
9. Surgical Treatment
Eventually, many people require surgery to correct ectropion. The type of surgery depends on the cause of the ectropion. If ectropion is due to reduced muscle tone in the eyelid, surgical removal of a small part of the eyelid corrects the problem.
In cases where an eyelid tumor is the cause of ectropion, the provider excises the tumor. An ectropion due to scarring may require a skin graft to support the lower eyelid properly.5‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/diagnosis-treatment/drc-20351169.
10. Post Surgery Care
For the first 24 hours after surgery, the person must wear an eye patch on the affected eye. The health care provider prescribes antibiotic and steroid solutions to be applied periodically to the eye. Using cold compresses on the eye helps reduce swelling and bruising.
Stitches are removed approximately a week after surgery, and bruising and swelling resolve over the course of a couple of weeks. Any initial tightness in the eyelid dissipates as healing takes place.5‘Ectropion.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 5 Jan. 2021, www.mayoclinic.org/diseases-conditions/ectropion/diagnosis-treatment/drc-20351169.
