Ectropion Lower Eyelid Reconstruction

Ectropion is an eversion or outward turning of the eyelid margin leading to loss of the normal apposition of the eyelid to the globe. Ectropion may be classified as congenital, involutional, paralytic, cicatricial, or mechanical. Involutional ectropion is caused by horizontal eyelid laxity of the medial and/or lateral canthal tendons. Cicatricial ectropion can be caused by the shortening of the anterior and/or middle lamella. Paralytic ectropion can be caused by CN VII paralysis or palsy resulting in loss of orbicularis oculi muscle tone. Lastly, mechanical ectropion can be caused by gravity, mass-effect of a tumor, fluid accumulation, herniated orbital fat, or poorly fitted spectacles. The patient may experience symptoms of corneal exposure, irritation, or epiphora due to ocular exposure, inadequate lubrication, and corneal disease. An individual is at increased risk with age, eyelid rubbing, excessing eyelid pulling or manipulation, contact lens use, skin conditions involving the lid, injury, or previous surgery.