Ectropion is a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury.

What is Ectropion ?

Ectropion is an atypical eversion (outward turning) of the eyelid margin faraway from globe. by and large, it includes lower eye lid however upper lid eversion might also arise in Floppy eyelid syndrome. Ectropion produces signs because of ocular (pertaining to eye) publicity and inadequate lubrication of eyeball. it is able to purpose epiphora, persistent conjunctivitis, conjunctival hypertrophy, publicity keratopathy or even visual loss.


Ectropion can be of following kinds:-


- Involutional
- Cicatricial
- Paralytic
- Congenital

Ectropion Symptoms

- Lid deformity.

- Foreign body sensation in eye.

- Redness of eyes.

- Tearing/ watering of eyes.

- Eye discharge.

- Pain in eyes.

- Photophobia (intolerance) to light.

- Corneal abrasion.

- Corneal ulceration.

- Dryness of eyes due to keratinisation.


Ectropion Causes

Involutional ectropion:


Involutional or senile ectropion is a not unusual shape of ectropion. It has many capabilities similar to involutional entropion adore it affects the lower lid of aged sufferers and the growing old modifications for both are similar. Following age related changes make a contribution to involutional ectropion.

- Horizontal lid laxity leads to immoderate eyelid length.


- weakness of pre-tarsal orbicularis oculi.


continual strain of ocular prosthesis in anophthalmic (absence of eyeball) socket may produce involutional ectropion.


Cicatricial ectropion:


Cicatricial ectropion is prompted because of scarring or contracture of pores and skin and underlying tissues. Anterior lamella comprising of pores and skin and orbicularis oculi muscle is shortened. This results in pulling away of the eyelid from the globe.


critical causes include:-


- Tumours


- Facial burns


- Trauma.


- excessive skin excision or laser burn in blepharoplasty (eyelid surgery).


Paralytic ectropion:


Paralytic ectropion may also occur with palsy of 7th cranial nerve. Paralytic ectropion is because of decreased tone of orbicularis oculi muscle due to its involvement in seventh cranial nerve palsy.


crucial reasons of seventh cranial nerve palsy are:-


- Bell palsy.


- Parotid gland infiltration or tumour.


- Cerebellopontine angle mass.


- Herpes zoster oticus.


Congenital ectropion:


Congenital ectropion is a rare bilateral situation. regularly the cause is vertical deficiency of anterior lamella.


Congenital ectropion may additionally arise in isolation or can be related to other conditions consisting of:-


- Blepharophimosis syndrome.


- Buphthalmos (Enlarged eyeball because of congenital glaucoma).


- Microphthalmos (small eyeball).


- Orbital cyst.


- Down syndrome.


Mechanical ectropion might also occur with lid tumours consisting of neurofibromas.


danger elements for Ectropion:


certain factors make contributions in development of ectropion inclusive of:-


- frequent rubbing of eyelids.


- Repeated pulling of eyelids (e.g. as in contact lens wearer).


- loss of lid elasticity with growing older.


- pores and skin conditions concerning eyelids.


- previous eyelid surgical operation.


- long time use of eye drops such as dorzolamide and brimodine.


- Inflammatory pores and skin situations related to eyelids.


- Trauma.


- Midfacial hypoplasia.

Ectropion Diagnosis

analysis relies upon upon elucidation of causative elements and scientific exam.

exam may display skills like:-

- symptoms of skin scarring, irritation or contamination.

- In hypoplastic midface, inferior orbital margin is located posteriorly relative to the globe.

- Eversion of eyelid.

- examination of lid margin structures may also moreover display madarosis (absence or lack of eye lashes), continual blepharitis, ulceration or infiltration.

- In punctal ectropion, punctum can also rotate away with medial laxity and no longer make touch with ocular floor.

- Conjunctival exam may additionally display dry eye features because of keratinisation precipitated through chronic inflammation, hypertrophy or scarring.

- Cornea can also additionally display abrasion, scarring, thinning, neovascularisation or ulceration.

Involutional Ectropion:

- affected character may show horizontal laxity of medial and/or lateral canthal tendons.

- Horizontal lid laxity: Horizontal lid laxity can be assessed through putting the thumb under lateral canthus and pushing the eyelid laterally and superiorly. Involutional ectropion disappears with this manoeuvre.

- Eyelid distraction check: Eyelid distraction check is performed through pulling the lid away from the globe. normal lid distraction is among 2-3mm. In horizontal lid laxity, distraction is more than 5mm.

- Snap again test: Examiner pulls lower lid inferiorly and check the lid returning to its precise characteristic without permitting affected individual to blink. commonly, lid returns returned speedy with out blinking, but in stepped forward laxity, blink may be needed for its go again to ordinary feature.

Cicatricial ectropion:

- Horizontal lid laxity: Horizontal lid laxity can be assessed via setting the thumb below lateral canthus and pushing the eyelid laterally and superiorly. If the decrease lid margin does not growth 2mm above the decrease limbus, then cicatricial ectropion is taken into consideration.

- In cicatricial ectropion, eyelid malposition regularly becomes accentuated with the aid of asking the affected man or woman to appearance upward and open mouth on the same time. with the useful resource of this manoeuvre, anterior lamella is maximally stretched.

Paralytic ectropion:

- signs of seventh cranial nerve palsy in conjunction with weak point of facial muscular tissues, disparity among spontaneous and voluntary closure of eyelid, presence or absence of Bell phenomenon and disability to close the eyelids may be present.

- publicity keratopathy because of incomplete blinking and lagophthalmos (incapability to shut the eyelids).

- Epiphora produced by way of failure of lacrimal pump mechanism and increase in tear production due to corneal publicity.

- Eyelid retraction.

- Deformity at the side of forehead ptosis.

Congenital ectropion:

- Congenital ectropion may display capabilities of related illness which consist of Blepharophimosis syndrome, microphthalmos (small eyeball) or Down syndrome.

Mechanical ectropion will display functions of associated tumour.

Ectropion want to be differentiated from situations like:-

- Eyelid retraction secondary to proptosis.

- Eyelid malignancy e.g. basal mobile carcinoma or squamous mobile carcinoma.