An ectropion is an out-turning of the eyelashes. There are many causes for this although the most common is laxity of the eyelid often associated with age.   Other causes include facial palsy, scarring of the skin and lesions affecting the eyelid. These would be discussed with you during your consultation if present.

An ectropion can cause the irritation to the eye and occasionally will reduce your vision.  This is usually because the tear film is not in the correct position to protect the eye.

The mainstay of treatment is surgery which is aimed at correcting the position of the eyelid.

We normally perform your surgery under local anaesthetic which is given in the operating room.  Occasionally we can give sedation at the same time if you are uncomfortable about having a local anaesthetic on its own.

The surgery itself involves making a small incision to the skin on the outer aspect of your eye socket. These incisions are made to be hidden within your natural skin creases.  The eyelid is repositioned and attached to the outer aspect of the eye socket.

Ectropion image

On occasion we may need to put extra stitches on the inside of the lower eyelid.  The sutures we use are dissolvable but sometimes they still need to be removed in clinic.

The surgery normally takes about 25 minutes per eyelid but can sometimes take longer.

This type of surgery is usually performed as a day case operation and we normally allow you to go home about 30 minutes after you surgery is finished.

The risks of surgery include postoperative bleeding, scarring to the eyelids and infection. We advise that you use an antiobiotic ointment after the surgery (see below) to help reduce the risk of infection.

Occasionally we may under or over correct the amount of skin that we remove and this can result in a different appearance between the eyelids. Sometimes the scar line can be slightly irregular with occasional small white cysts forming. Most of these complications can be corrected if needs be with a second operation.

The most serious risk of any eyelid surgery performed is damage to your eyesight.  Fortunately this risk is extremely rare.

The eyelids will be bruised after surgery and you may have some bloodstained tears which is quite normal initially.

You should avoid any strenuous activity including lifting heavy objects for a least a week and avoid swimming for three weeks after surgery.

You should avoid any strenuous activity including lifting heavy objects for at least two weeks and avoid swimming for three weeks after surgery.

We will give you some antibiotic ointment (usually Chloramphenicol) to apply to the wounds and to the eyes after the surgery to help protect against infection and to help lubricate the eyes for two weeks

We advise that you apply ice compresses to the eyelids after surgery for three times a day for 5 minutes each time. This is to help reduce the bruising.

We normally see you after surgery to check the position of the eyelid.

Usually patients are quite anxious after having surgery near their eyes and most problems do settle with time. Problems that require immediate attention are the onset of new double vision, loss of vision and pain that cannot be controlled with regular painkillers.  In particular if the eyelid swells up and you cannot open your eye then this requires an urgent review.  Please refer to the emergency contact page (in contacts).

 

Author: Mr Jonathan Norris FRCOphth