An ectropion is an outwardly turned or sagging lower eyelid.
The sagging lower eyelid fails to remain in contact with the eyeball and leaves the surface of the eye and eyelid exposed and dry. This causes the tears to pool and the eye to water persistently.
If left untreated, ectropion can cause the eye to water and eventually stenotic changes of the tear drainage apparatus. If the ectropion is secondary to facial palsy, then there can be sensitivity to light and wind, scratches and infections of the surface of the eye, which may be sight, threatening. If ectropion is present, it is important to have the condition treated before permanent damage occurs to the eye.
Ectropion most commonly occurs due to changes in muscles and other tissues as a result of ageing causing them to become weak. Ectropion can also occur due to weakness of the facial muscles (Bells Palsy or facial palsy), and from scarring of the eyelid skin due to injury, especially burns or road traffic accidents, which causes the lid to turn outwards or sag.
How can ectropion / sagging lower eyelid be treated?
Temporary relief of the irritation from ectropion can be achieved by using artificial tears and ointments to help lubricate the eye.
Surgery is the only treatment option for the vast majority of ectropions due to aging changes. These can be addressed by tightening the lid at its outer corner and may need additional supported at the inner corner of the eyelid. Ectropions due to facial palsy, trauma etc are more complex and need almost all the causative factors addressed, in order to reduce chances of recurrence. Some of these ectropions would require a mid face lift, skin grafts etc and these options will be discussed with you by your surgeon.
Surgical Correction for Sagging Lower Eyelid
The aim of surgical correction is to restore the anatomy, by addressing the various causative factors. Depending upon the cause of entropion, surgery can range from a simple 30-minute procedure to a more complicated 90-minute procedure.
What are the potential risks & complication
of surgical lower eyelid correction?
Minor bruising or swelling, which settles in 1-3 weeks can be expected. Bleeding and infection, which are potential risks with any surgery, are very uncommon. Occasionally the outer corner of the eyelid may look a bit smaller than before – the so called “Chinese eyed” appearance, generally this tends to correct itself over 4-12 weeks. Rarely the ectropion can recur.