From the Guidelines
Ectropion is primarily caused by age-related weakening of the muscles and tendons that hold the lower eyelid in position, allowing it to turn outward, as well as other factors such as facial nerve paralysis, scarring, and skin conditions. This condition can lead to symptoms like dryness, irritation, excessive tearing, and potential corneal damage if left untreated. The causes of ectropion can be categorized into:
- Age-related weakening of the muscles and tendons
- Facial nerve paralysis (Bell's palsy) 1
- Scarring from trauma or burns
- Previous eyelid surgeries
- Skin conditions like dermatitis or psoriasis
- Congenital factors present at birth
- Certain medications that cause skin tightening, such as some chemotherapy drugs
According to the most recent evidence, the primary aim of ophthalmic management is to maintain normal visual development and protect the ocular surface integrity while minimizing the risk of corneal epithelial defects 1. Treatment depends on the underlying cause but may include artificial tears for mild cases, while more severe cases typically require surgical correction to tighten the eyelid and restore its normal position against the eye. Frequent ocular lubricants are highly recommended as a first-line treatment for all patients with ectropion 1. Additionally, eyelid skin grafting may be considered as a third-line therapy for symptomatic corneal exposure or epiphora that persists despite adequate conservative treatments 1.
From the Research
Ectropion Causes
- Ectropion is classified as congenital (primary and secondary) and acquired (involutional, paralytic, mechanical, and cicatricial) 2
- Involutional ectropion is the most frequent form of acquired eyelid eversion and is a result of multiple factors 2
- Cicatricial ectropion is caused by the shortening of the anterior lamella of the lid, secondary to congenital malformations, trauma, burns, skin conditions, scarring skin tumors, medications, allergies, blepharoplasty complications, and involutional changes that result in loss of skin elasticity 2
- Mechanical ectropion is caused by eyelid tumors or inflammatory disorders that cause orbicularis spasm 2
- Paralytic ectropion is associated with facial paralysis, which can lead to lagophthalmos, exposure keratopathy, and other ophthalmic complications 3
- Ectropion can also be caused by facial palsy, which can result in weakness or paralysis of the facial muscles, including the orbicularis oculi muscle 4
Types of Ectropion
- Congenital ectropion is rare and is usually associated with other malformations such as euryblepharon, ptosis, epicanthus inversus, and blepharophimosis syndrome 2
- Acquired ectropion is the most prevalent type and is further divided into involutional, paralytic, mechanical, and cicatricial subtypes 5
- Involutional ectropion is the most common type of acquired ectropion, with no patient population bias 5