We don’t often think about our eyelids other than to moisturize them and complain when they start to loosen and sag. The eyelids fill a crucial role in eye health, too. We just don’t think about that very often, if at all. This part of the eye is responsible for spreading the tear film that keeps the eyes moistened. The eyelids also keep debris from getting into the eye. For this to occur effectively, though, the eyelid must fit well against the eye. Sometimes, this fit is compromised. This is referred to as ectropion.
What is Ectropion of the Eye?
Ectropion is the term that describes an outward turn of the lower eyelid. Tissue doesn’t always turn outward; it is more of a droop that results in the eyelid pulling away from the eyeball. Without good contact between the eyelid and the eye, symptoms such as excessive tearing, chronic dry eye, a burning sensation, and recurrent infections can occur.
Not everyone is at risk for ectropion. There are a few different reasons that this problem may occur. They include:
- Age-related changes to the eyelid. This is called involutional ectropion and it happens when the connective tissue that holds the eyelid against the force of gravity degrades. Without sufficient structure, which stems from strong collagen and elastin proteins, the eyelid falls outward.
- Abnormal contractions of the eyelid. This is referred to as cicatricial ectropion. It occurs when the muscle that is used to blink does not contract properly. Usually, abnormal contraction is the result of scar tissue.
- Nerve damage. People who have had a stroke may develop what is called paralytic ectropion as a result of damage to a facial nerve.
- A mass on the eyelid. Muscle contractions may also be disrupted by a mass or tumor. This problem is referred to as mechanical ectropion.
Initially, ectropion may be treated by managing symptoms. For example, a doctor may prescribe lubricating eye drops to prevent the problems that occur without good eyelid structure. Management can help but does not prevent ectropion from worsening. In some cases, it is necessary to operate on the lower eyelid to restore proper function. This may involve the gradual stretching of scar tissue if that is causing abnormal contractions. Repair may involve removing a small portion of the eyelid or removing a growth to tighten tissue against the eyeball. Ectropion procedures are usually performed on an outpatient basis and patients recover at home over a few weeks.