Ectropionu

Ectropionu is a medical condition in which the margin of the eyelid turns outward away from the eyeball, most often involving the lower lid. This outward turning exposes the palpebral conjunctiva, can disrupt normal tear drainage, and frequently causes tearing, irritation, and conjunctival redness. Ectropionu can affect one or both eyes and is more common in older individuals.

Causes and classification include several main types. Involutional (senile) ectropionu results from age-related laxity of the eyelid tissues. Cicatricial ectropionu arises from scarring after burns, dermatitis, surgery, or inflammatory disease. Mechanical ectropionu is due to a mass or edema that pulls the lid away from the eye. Paralytic ectropionu occurs with facial nerve palsy, which weakens eyelid tone. Pseudoectropionu describes an appearance of lid malposition caused by lid edema or retraction rather than true lid turning.

Symptoms typically include excessive tearing (epiphora), ocular irritation or a burning sensation, a feeling of a foreign body, redness, and lid heaviness. In advanced cases, exposure can lead to conjunctival inflammation or corneal irritation, ulcers, or scarring if untreated.

Diagnosis is clinical, based on observation of lid position, lash direction, and conjunctival exposure. Slit-lamp exam assesses corneal health and tear film. Differential includes entropion (lid turning inward) and ptosis.

Treatment ranges from conservative to surgical. Mild cases may improve with lubricating eye drops or ointments, lid hygiene, and addressing inflammation. Procedures to tighten or reposition the lid, such as canthoplasty or canthopexy, are commonly used for involutional ectropionu. Cicatricial or paralytic forms may require scar revision, skin grafts, eyelid weights, or tarsorrhaphy. Prognosis improves with appropriate management; untreated ectropionu risks chronic conjunctivitis, keratitis, and vision problems.