Ectropion

Diagnosis

Ectropion can usually be diagnosed with a routine eye exam and physical. Your doctor may pull on your eyelids during the exam or ask you to close your eyes forcefully. This helps him or her assess each eyelid's muscle tone and tightness.

If your ectropion is caused by a scar, tumor, previous surgery or radiation, your doctor will examine the surrounding tissue as well.

Understanding how other conditions cause ectropion is important in choosing the correct treatment or surgical technique.

Treatment

If your ectropion is mild, your doctor might recommend artificial tears and ointments to ease the symptoms. Surgery is generally required to fully correct ectropion.

Surgery

The type of surgery you have depends on the condition of the tissue surrounding your eyelid and on the cause of your ectropion:

• Ectropion caused by muscle and ligament relaxation due to aging. Your surgeon will likely remove a small part of your lower eyelid at the outer edge. When the lid is stitched back together, the tendons and muscles of the lid will be tightened, causing the lid to rest properly on the eye. This procedure is generally relatively simple.
• Ectropion caused by scar tissue from injury or previous surgery. Your surgeon might need to use a skin graft, taken from your upper eyelid or behind your ear, to help support the lower lid. If you have facial paralysis or significant scarring, you might need a second procedure to completely correct your ectropion.

Before surgery, you'll receive a local anesthetic to numb your eyelid and the area around it. You may be lightly sedated using oral or intravenous medication to make you more comfortable, depending on the type of procedure you're having and whether it's done in an outpatient surgical clinic.

After surgery you might need to:

• Wear an eye patch for 24 hours
• Use an antibiotic and steroid ointment on your eye several times a day for one week
• Use cold compresses periodically to decrease bruising and swelling

After surgery you will likely experience:

• Temporary swelling
• Bruising on and around your eye

Your eyelid might feel tight after surgery. But as you heal, it will become more comfortable. Stitches are usually removed about a week after surgery. You can expect the swelling and bruising to fade in about two weeks.

Lifestyle and home remedies

These lifestyle tips may relieve your discomfort from ectropion:

• Use eye lubricants. Artificial tears and eye ointments can help keep your cornea lubricated and prevent vision-threatening damage. Using an eye ointment and wearing a moisture shield over your eye is particularly useful overnight.
• Wipe your eyes carefully. Constantly wiping watery eyes can make your under-eye muscles and tendons stretch even further, worsening your ectropion. Wipe from the outer eye up and in toward the nose.

Preparing for your appointment

If you have signs and symptoms of ectropion, you're likely to start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in treating eye disorders (ophthalmologist).

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment take these steps:

• List symptoms you've been having and for how long.
• Find a photo of yourself before the appearance of your eyelid changed that you can bring to the appointment.
• List all medications, vitamins and supplements you take, including the doses.
• List key personal and medical information, including other conditions, recent life changes and stressors.
• List questions to ask your doctor.
• Ask a relative or friend to accompany you, to help you remember what the doctor says.

For ectropion, some basic questions to ask your doctor include:

• What's the most likely cause of my symptoms?
• What kinds of tests do I need? Do they require any special preparation?
• Is this condition temporary or long lasting?
• Can ectropion damage my vision?
• What treatments are available, and which do you recommend?
• What are the risks of surgery?
• What are the alternatives to surgery?
• I have these other health conditions. How can I best manage them together?
• Do you have any brochures or other printed material that I can take with me? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• Have you had any previous surgery or procedures on your eye or eyelid?
• Have you had any radiation treatments of your head and neck?
• Have you had any other eye problems, such as an eye infection or an injury?
• Are you taking any blood thinners?
• Are you taking aspirin?
• Are you using any eyedrops?