Lower Eyelid Ectropion

Lower eyelid ectropion is an eyelid malposition in which the lower eyelid margin is turned away from its normal position in contact with the eye. The condition is commonly age-related but can also occur in patients with skin problems e.g. severe eczema, following an injury/burn, or in patients with a facial palsy. The ectropion leads to overflow tearing of the eye (epiphora) and discomfort. This can lead to a vicious cycle of secondary events and needs to be addressed early. Epiphora may lead to irritation and contraction of the skin of the lower eyelid that further worsens the ectropion. In addition, the patient tends to continually wipe the lower eyelid, which in turn results in eyelid stretching that further worsens the lower eyelid ectropion. If the condition is neglected, the conjunctiva on the inside surface of the eyelid becomes exposed and eventually thickened. The patient's eye may show associated dryness.

Management
The treatment of the ectropion depends on the underlying cause. Most patients undergo surgery to tighten the eyelid at the outer aspect of the eyelids (a lateral tarsal strip procedure). Some patients with shortening of the skin of the eyelids require a skin graft. This can be taken from the upper eyelid, from behind the ear or from the upper inner arm.

Consultants who undertake this procedure:

Saj Ataullah
Anne Cook
Brian Leatherbarrow
Ahmed Sadiq