Ektropium

Ektropium, often spelled ectropion in medical literature, is a condition in which the eyelid margin turns outward away from the globe. It most commonly affects the lower eyelid and can lead to exposure of the conjunctiva, tearing, and irritation due to impaired tear distribution.

The condition is typically categorized by its cause. Involutional or senile ectropion results from age-related widening and laxity of the eyelid tissues. Cicatricial ectropion arises from scarring of the eyelid skin or underlying tissues, often due to burns, dermatitis, or previous surgeries. Mechanical ectropion occurs when a mass or swelling pulls the eyelid away from the eye. Paralytic ectropion is associated with facial nerve palsy or other neuromuscular disorders that weaken the muscles around the eyelid. Congenital ectropion is rare and present at birth, often involving multiple eyelid abnormalities.

Patients with ectropion typically report chronic tearing (epiphora), a gritty or foreign body sensation, redness, and irritation of the eye. The conjunctiva may be chronically exposed and inflamed, and prolonged exposure can lead to corneal irritation or ulcers if untreated. Diagnosis is based on clinical examination of eyelid position and the eye, with slit-lamp inspection to assess the cornea and tear film.

Treatment is tailored to the cause and severity. Mild cases may respond to lubricating eye drops, ointments, and measures to protect the ocular surface. Addressing contributing skin conditions or dermatitis is important. Definitive management usually involves surgery: canthoplasty or canthopexy to restore lid support, lateral or medial canthal repositioning, and, in cicatricial disease, scar release with grafts or local flap reconstruction. Severe exposure may require temporary or permanent tarsorrhaphy to protect the cornea.