Sunday, January 15, 2006

ectropion (outward turning lid)

Ectropion is the turning outward of the margin of the eyelid, resulting in the exposure of the bulbar and palpebral conjunctiva (white of the eye). Ectropion is most frequently seen in the elderly due to a decrease in muscle tone and loss of fat around the eye. Symptoms result from exposure of the conjunctiva and cornea. When the lower eyelid is involved, the inferior punctum (entrance to tear duct) is not adjacent to the lacrimal lake and tearing may occur. Other symptoms include a foreign body sensation and an increased incidence of chronic infection. Ectropion occurs in several forms: atonic, cicatricial, spastic, and conjunctival. Atonic ectropion is caused by a lack of tone in the eyelid; whereas cicatricial is from scar tissue from a previous infection or inflammation. Spastic ectropion results from a tightness of the eyelid muscles around the eye. Conjunctival ectropion is caused by a previous infection. The lower lid is involved in the atonic type, but the cicatricial and conjunctival types may involve either the upper or lower eyelid.
Treatment for ectropion is surgery usually done on an outpatient basis. Between diagnosis of the condition and surgery the person with ectropion should be encouraged to wipe the tears with an up and inward movement and to use artificial tears as needed for comfort.
Newell, F. W. Ophthalmology Principles and Concepts, 6th ed. St. Louis: C. V. Mosby Co., 1986.
Slatt, B. J., and Stein, H. A. The Ophthalmic Assistant Fundamentals and Clinical Practice, 4th ed. St. Louis: C. V. Mosby Co., 1983.

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