Eversion of the eyelid

Eversion of the eyelid

In this article, we will tell you:

Eversion of the eyelid ( ectropion ) is a condition in which the edges of the eyelids and eyelashes partially or completely turn outward, the conjunctiva is exposed, becomes more susceptible to irritation.

Lower eyelid ectropion is most common in the elderly, but it can also occur in children. For example, this may be due to excessive muscle tension (spasm), and eversion of the eyelid may also be congenital.

Signs and symptoms of eversion of the eyelids, in which it is worth contacting an ophthalmologist:

  • The eyelid looks droopy or drooping, loosely attached to the eyeball;
  • Inability to close eyes completely;
  • Dryness of the eye, a feeling of sand or a foreign body due to the fact that the tear does not completely wet the surface of the eye;
  • Excessive tearing in response to dry eyes;
  • Frequent blinking;
  • Increased photosensitivity;
  • Redness (hyperemia), irritation, burning.

This is dangerous?

As a rule, no. The loss of elasticity of the eyelids, which protect our eyes from mechanical damage, of course, can cause discomfort. For example, if you often remove excess tears with your hands or with a handkerchief, there is a high probability of infecting and earning conjunctivitis. Usually the disease proceeds quietly and may have minimal manifestations. Patients with eyelid eversion go to the doctor mainly because of a cosmetic defect or with complaints of incomplete closure of the eyes.

In rare advanced cases, eversion of the eyelids can cause damage to the cornea and further inflammation (keratitis). For prevention, it is important to undergo an ophthalmological examination at least once a year in order to notice the pathology in time and avoid visual impairment.

What can cause eyelid misalignment?

The most common factor that contributes to eversion of the eyelids is weakness of the circular muscles of the eyes, loss of skin due to natural age-related changes, and atrophy of the subcutaneous tissue. Due to the instability of these structures, the eyelids and the ciliary margin may turn outward ( ectropion ) or inward (entropion).

Also, the cause of inversion and eversion can be in:

  • Paralysis of the facial nerve after a stroke (paralytic eversion of the eyelid);
  • Problems of innervation of the oculomotor muscles – with spasm, an inversion of the eyelid and eyelashes may occur, with insufficient tone – eversion;
  • Inflammatory eye conditions such as blepharitis or conjunctivitis. They are able to cause spasm of the circular muscle of the eye and increase the risk of developing this pathology;
  • Autoimmune diseases (systemic lupus erythematosus, scleroderma, dermatomyositis);
  • Injuries to the eyelids in the past (injuries, ruptures, burns, undergone plastic surgery);
  • Down’s syndrome, Miller’s syndrome.

Types of eyelid eversion

Depending on the cause, the following forms of pathology are distinguished:

  • Senile, or age-related (physiological aging, in which muscle tone decreases and tendons are stretched);
  • Paralytic (due to a stroke, usually also accompanied by drooping of the upper eyelid, eyebrows, asymmetry of the lips, cheeks, lack of mobility on the affected side of the face);
  • Cicatricial, when there is a contraction and fusion of the edges of the eyelids due to scars;
  • Congenital (genetic anomalies, intrauterine developmental disorders of the eyelids);
  • Mechanical (after injuries).

Diagnosis and treatment of eversion of the lower eyelid

The doctor chooses the tactics of treatment only after collecting an anamnesis, conducting an examination and finding out the cause of the violation.

The specialist will need to conduct the following examinations to make a diagnosis:

  • External examination and viziometry – checking visual acuity according to the table;
  • Biomicroscopy – a detailed study of the eyelids, conjunctiva, cornea, iris, anterior chamber of the eye, lens and vitreous body;
  • Examination of the fundus and retina on a slit lamp using a special lens;
  • Measurement of the width of the palpebral fissure.

Therapy begins with symptom relief and getting rid of the root cause. Your optometrist may recommend moisturizing eye drops or ointments to relieve dryness. To prevent inflammatory processes and complications, local anti-inflammatory drugs are prescribed.

At the request of the patient, the defect is eliminated with the help of surgical intervention – blepharoplasty is performed. The operation allows you to restore the correct position and shape of the eyelids, restore their mobility and save the patient from often disturbing conjunctivitis and irritation. Depending on the root cause of the pathology, the correction may be different:

  • Aimed at strengthening the ligaments of the lower eyelid;
  • Scar removal and transplantation of healthy tissue;
  • Elimination of neoplasms.

This solution to the problem is optimal for eversion of the eyelids. Of course, like any surgical treatment, blepharoplasty has a number of contraindications that you can discuss with your doctor.

The operation is clearly contraindicated:

  • With a decrease in coagulation (blood coagulation) due to genetic characteristics or medication;
  • Connective tissue diseases (when the cause of eyelid eversion lies in autoimmune pathologies);
  • Decompensated diabetes mellitus, diabetic angiopathy or retinopathy;
  • Disorders of the thyroid gland ( hypo – or hyperthyroidism );
  • Tuberculosis;
  • Postponed heart attack or stroke;
  • Retinal detachment;
  • Immunodeficiency.

Among the temporary contraindications, due to which experts will recommend postponing the operation, include:

  • Pregnancy, lactation;
  • Acute infectious diseases, regardless of their location (conjunctivitis, tonsillitis, pneumonia, gastritis, pancreatitis);
  • Increased intraocular pressure.

The period of complete rehabilitation after surgical treatment is relatively short – from three to five weeks. During the first two weeks, swelling and bruising are usually observed, as well as dryness and severe photosensitivity of the eyes. For the fastest recovery, doctors recommend:

  • Limit visual load;
  • Avoid exposure to bright sunlight;
  • Use antibacterial drops to prevent infection;
  • Temporarily stop wearing contact lenses and applying cosmetics;
  • Do not visit the bath, sauna, solarium, suspend household and physical activity.

Remember: regular preventive examinations by an ophthalmologist help to timely detect any eye diseases, including eversion and inversion of the eyelids, and increase the chances of a quick recovery.

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