Materiały źródłowe

• #1 Ectropion – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441929/

  Ectropion is an outward turning of the eyelid margin. This activity reviews the cause and pathophysiology of ectropion and highlights the role of the interprofessional team in its management. […] The most common etiologic factor of lower eyelid ectropion is involutional change, caused by horizontal eyelid laxity and disinsertion of the lower eyelid retractors. […] Paralytic ectropion may occur with facial nerve palsy. […] Cicatricial ectropion may be caused by scarring and shortening of the anterior lamella of the lower eyelid skin, which may also occur with aggressive lower eyelid blepharoplasty. […] Mechanical ectropion may be caused by a mass, such as a tumor, herniated fat, or edema of the lower eyelid, weighing down and pulling the lower eyelid outward. […] Treatment is based on correcting the underlying etiology leading to ectropion.

• #2 Ectropion – EyeWiki

  https://eyewiki.org/Ectropion

  Ectropion is an outward turning of the eyelid margin. […] In involutional ectropion, the tarsoligamentous sling supporting the eyelid by attachment to the orbital rim via the medial and lateral canthal tendons becomes lax. […] In paralytic ectropion, orbicularis muscle tone is weak or absent due to facial nerve palsy. […] In cicatricial ectropion, the anterior or middle lamellae are shortened due to scarring. […] Midfacial hypoplasia, where the inferior obital rim is located relatively posterior to the eyeball, results in both decreased lower eyelid support and increased propensity for lower eyelid retraction.

• #3 Ectropion | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2024/01/clinical-review/ectropion

  In ectropion, the eyelid margin typically the lower eyelid is turned outward. This condition is becoming increasingly common due to the ageing population. Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional, paralytic, mechanical and cicatricial subtypes. Involutional ectropion is the most common where there is no patient population bias. […] Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional (age-related), paralytic, mechanical and cicatricial (scar-related) subtypes. This clinical review provides an overview of the condition and is based on a selective review of the literature and the authors’ experiences in clinical practice.

• #4 Ectropion: Causes, Assessment, & Treatment

  https://www.theplasticsfella.com/ectropion/

  Ectropion is the eversion of the lower eyelid resulting in exposure of the globe, conjunctiva and sometimes the cornea. It may have paralytic, involutional, cicatricial, mechanical and congenital (rare) aetiology. […] Involutional ectropion is the most common cause of lower eyelid eversion. It results from abnormal laxity in the lid support system. More specifically: […] Laxity of the medial canthal tendon displaces the punctum laterally. […] Laxity of lateral canthal tendon displaces the lateral canthus medially. […] Atrophy of skin, fat, tarsal plates, and orbital septum. […] Weakening of the pretarsal orbicularis causes tarsal plate eversion. […] Dehiscence of capsulopalpebral fascia and Muller muscle destabilises tarsus. […] The clinical assessment should determine type of ectropion, functional impact, degree of horizontal lid laxity, and integrity of the canthal tendons.

• #5 Arquivos Brasileiros de Oftalmologia – Eyelid aging: pathophysiology and clinical management

  https://www.aboonline.org.br/details/2117/en-US/eyelid-aging–pathophysiology-and-clinical-management

  Recently, a decrease in elastic fibers with ultrastructural abnormalities and an overexpression of elastin-degrading enzymes have been demonstrated in involutional ectropion and entropion. […] Overexpression of elastin-degrading enzymes in involutional ectropion and entropion specimens may be the consequence of local ischemia, inflammation, and/or chronic mechanical stress. […] Damasceno et al. have demonstrated an overexpression of elastolytic enzymes, such as MMP-9, MMP-7, and MMP-2. […] The lateral laxity of the canthal tendon is the most important reason for the appearance of involutional ectropion and entropion. […] Some studies reported the presence of abnormal elastic fibers in involutional ectropion and entropion; however, they did not measure them nor did they address the possible reasons for the abnormal fibers.

• #6 Lower Eyelid Malpositions

  http://webeye.ophth.uiowa.edu/eyeforum/tutorials/lower-eyelid-malpositions/index.htm

  Cicatricial ectropion is less common than involutional ectropion, and occurs due to shortening of the anterior lamella. […] The goal in treating cicatricial ectropion is to lengthen the anterior lamella and stabilize the lid. […] Paralytic ectropion most commonly occurs secondary to facial nerve palsy. […] Decreased orbicularis oculi muscle tone exacerbates any pre-existing horizontal eyelid laxity and can lead to ectropion, retraction of the lower lid, and lagophthalmos. […] Mechanical ectropion occurs due to the effect of gravity from a large lesion of the eyelid or cheek, edema, or mechanical weight from significant facial ptosis.

• #7 Bell Palsy: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/1212398-overview

  The precise pathophysiology of Bell palsy remains an area of debate. The facial nerve courses through a portion of the temporal bone commonly referred to as the facial canal. A popular theory proposes that edema and ischemia result in compression of the facial nerve within this bony canal. The cause of the edema and ischemia has not yet been established. This compression has been seen in MRI scans with facial nerve enhancement. […] The first portion of the facial canal, the labyrinthine segment, is the narrowest; the meatal foramen in this segment has a diameter of only about 0.66 mm. This is the location that is thought to be the most common site of compression of the facial nerve in Bell palsy. Given the tight confines of the facial canal, it seems logical that inflammatory, demyelinating, ischemic, or compressive processes may impair neural conduction at this site.

• #8 Bell Palsy: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/1212398-overview

  Injury to the facial nerve in Bell palsy is peripheral to the nerves nucleus. The injury is thought to occur near, or at, the geniculate ganglion. If the lesion is proximal to the geniculate ganglion, the motor paralysis is accompanied by gustatory and autonomic abnormalities. Lesions between the geniculate ganglion and the origin of the chorda tympani produce the same effect, except that they spare lacrimation. If the lesion is at the stylomastoid foramen, it may result in facial paralysis only.

• #9 Cicatricial Ectropion – EyeWiki

  https://eyewiki.org/Cicatricial_Ectropion

  Cicatricial ectropion occurs due to the shortening of the anterior lamella, which comprises of skin and orbicularis. Scarring or shortening of the anterior lamella causes outward rotation of the lid margin. […] There are various causes of anterior lamellar shortening leading to cicatricial ectropion, some of the important causes of cicatricial ectropion include mechanical, chemical or thermal injury, skin diseases, and excessive skin removal during lower lid blepharoplasty. […] To effectively manage cicatricial ectropion, it is important to have a proper understanding of various phases of wound healing and types of scar. […] The scar is formed as a consequence of wound healing in which the normal skin is replaced by fibrous tissue. An ideal scar is thin and flat, has a color matching with the surrounding skin, and is oriented along the relaxed skin tension lines.

• #10 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion

  https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en

  Cicatricial ectropion may be a consequence of certain systemic diseases as well as the result of drug use. […] A detailed PubMed literature search indicated many different etiologies were associated with cicatricial ectropion development, from severe cases of systemic diseases, such as ichthyosis and lupus erythematosus, to reversible scenarios secondary to anti-glaucomatous drug use. […] Cicatricial ectropion is characterized by a vertical shortening of the eyelid, due either to loss of skin elasticity or a lack of tissue in the anterior lamella. […] Factors that could cause these changes are remarkably diverse and include trauma, burns, actinic skin changes, medications, and blepharoplasty complications. […] Recent publications also present a remarkable diversity of new possible causes, such as osteonecrosis secondary to treatment with bisphosphonate, periorbital necrotizing fasciitis, blastomyces dermatitidis, frontal bone osteomyelitis, generalized eruptive keratoacanthomas of the Grzybowski type, and other similar pathologies.

• #11 Ectropion in Dermatologic Surgery: Exploration and Reconstruction Techniques | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-ectropion-in-dermatologic-surgery-exploration-articulo-S1578219020300251

  There are 5 types of ectropion: congenital, paralytic, involutional, cicatricial, and mechanical. Congenital ectropion is extremely rare and usually occurs due to vertical skin foreshortening in blepharophimosis syndrome. Paralytic ectropion is caused by paresis of the orbicularis oculi muscle, generally as a result of facial nerve paralysis. Involutional or senile ectropion is the most frequent type, and is caused by laxity, atrophy, or disinsertion of the supporting structures (tarsus, orbital septum, ligaments, canthal tendons, and retractors), and loss of elasticity and decreased orbital and malar fat. Cicatricial and mechanical ectropion are due to a vertical vector that exerts a tractional force on the eyelid. In cicatricial ectropion, the most frequent cause is foreshortening of the anterior lamella due to mechanical, chemical, or thermal damage or postoperative cicatricial retractions. The most common causes of mechanical ectropion include periorbital edema and tumors.

• #12 Ectropion Lower Eyelid Reconstruction | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20890

  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 or lateral canthal tendons. The shortening of the anterior or middle lamella can cause cicatricial ectropion. Paralytic ectropion can be caused by seventh or facial cranial nerve paralysis or palsy, resulting in loss of orbicularis oculi muscle tone. Lastly, mechanical ectropion can be caused by gravity, the mass effect of a tumor, fluid accumulation, herniated orbital fat, or poorly fitted spectacles. […] Anterior lamellar shortening is often the primary cause of cicatricial ectropion; any associated connective tissue or other medical disorders must be addressed, controlled, and stabilized before definitive surgical correction is considered.

• #13 Ectropion | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2024/01/clinical-review/ectropion

  Age-related (involutional) acquired ectropion typically presents with bilateral involvement. This is the most common subtype of ectropion and is due to age-related changes in the elastic and collagen fibres of the skin and connective tissue. These changes lead to a loss of skin tightness, weakening of the attachment points of the orbicularis muscle, and loosening of the lateral canthal tendon (tissue strands that attach the eyelids to the lateral orbital rim) (Figure 1). The result is eyelid eversion. […] Unlike involutional ectropion, paralytic ectropion is normally unilateral. This subtype is caused by peripheral facial nerve palsy. As the orbicularis muscle is innervated by the facial nerve, peripheral facial nerve palsy can lead to ectropion. […] Mechanical ectropion, as the name suggests, results from the weight of a mass pulling the lower eyelid down and outwards. Oedema and tumours on the lower eyelid can, due to the gravitational force, exert downward traction on the lower eyelid, causing it to turn outward.

• #14 Ectropion: Classification, Diagnosis, and Management | Consultant360

  https://www.consultant360.com/articles/ectropion-classification-diagnosis-and-management

  Paralytic ectropion can result from a seventh cranial nerve palsy, stroke, tumor, or surgical complication. […] Cicatricial ectropion can occur at any age and can be a result of a chemical burn, scar, or surgery. In this condition, there is a mechanical shortening of the anterior lamellae of the eyelid. […] This anatomical shortening will cause the eyelid to be pulled down and can lead to an excess of tearing, because the tears will not drain through the puncta but instead flow over the eyelid margin. […] Mechanical ectropion is much less common, because a specific offending anatomical agent must be present. Offending agents that can force the eyelid away from the eye include dermatochalasis, edema, chalazion, orbital fat, or an eyelid tumor. […] Treatment depends on the type of ectropion.

• #14 Ectropion: Classification, Diagnosis, and Management | Consultant360

  https://www.consultant360.com/articles/ectropion-classification-diagnosis-and-management

  Ectropion, or the malposition of the eyelid turning away from the globe, can be the cause of epiphora and dry eyes. […] Chronic exposure of the globe and palpebral conjunctiva can lead to reflex tearing and dry eye symptoms. […] If an ectropion leads to the exposure of the punctum, this structure can become stenotic and further contribute to the symptoms of epiphora. […] If the cornea remains exposed for any period of time, it increases the risk of epithelial breakdown, which may lead to infectious keratitis. […] Involutional ectropion is the most common acquired cause. The incidence of the condition increases with age. Involutional factors, including horizontal lid laxity and vertical lid instability, are present in these patients. […] Patients with involutional ectropion initially might be asymptomatic, given that this is a gradually worsening condition.

• #15 Ectropion | PPT

  https://www.slideshare.net/slideshow/ectropion-237950652/237950652

  PATHOGENESIS OF ECTROPION Initial sign of a lower lid ectropion is inferior punctal eversion this leads to a vicious cycle of secondary events Eversion of inferior punctum exposure and drying of punctum stenosis Epiphora excoriation and contracture of skin of lower eyelid that further exacerbates ectropion […] Patient tends to continually wipe tears Eyelid and medial canthal tendon laxity that further exacerbates lower eyelid ectropion If condition is neglected, tarsal conjunctiva becomes exposed and eventually thickened and keratinized Lower lid ectropion often results in a corneal epitheliopathy, especially in inferior third of cornea […] It should be directed towards recognition of the ectropion and its severity 1. Severity of ectropion: Mild : The lower punctum is everted Moderate : The tarsal conjunctiva is exposed Severe : The lower fornix is exposed 2. Extent of ectropion: Medial or lateral or involving the entire lower eyelid 3. Presence of any traumatic or surgical scar tissue.

• #16 Involutional ectropion

  https://webeye.ophth.uiowa.edu/eyeforum/cases/218-ectropion.htm

  Ectropion is one of the most commonly encountered eyelid disorders seen in ophthalmology. […] The most common entity causing this disorder is involutional ectropion. Patients with this disorder frequently experience symptoms of ocular irritation including redness, discharge, papillary conjunctival reaction and corneal epitheliopathy. […] Findings on examination which support the diagnosis of involutional ectropion include poor apposition of the eyelid to the globe, poor snap back test (inability of the eyelid to return to its normal position apposed to the globe after being manually pulled away), positive distraction test (ability to pull eyelid 6mm from the globe), and outward turned lashes. […] The most common anatomic changes leading to involutional ectropion are horizontal eyelid laxity, lamellar dissociation, and retractor disinsertion.

• #17 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports

  https://www.nature.com/articles/s41598-025-88138-6

  This study investigated potential associations between ectropion and various chronic and systemic inflammatory diseases affecting the eyelids and ocular surface. […] Significant associations were found between involutional ectropion and several local inflammatory eyelid diseases: blepharitis (OR 4.66), chalazion (OR 2.94), hordeolum (OR 2.26), and dermatitis of the eyelid (OR 2.46). Ocular surface diseases associated with ectropion included chronic conjunctivitis (OR2.89) and pterygium (OR 2.48). […] This anatomical alteration of the eyelid margin manifests as involutional malposition, with a predilection for the lower eyelid compared to the upper eyelid. […] Using data from the Clalit Health Services (CHS) in the southern district of Israel some members of the research team found an association between inflammatory conditions and the development of involutional ectropion.

• #18 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports

  https://www.nature.com/articles/s41598-025-88138-6

  The observed association between conditions of periocular inflammation, such as blepharitis, chalazion, hordeolum, dermatitis of the eyelid and involutional ectropion could be explained by various inflammatory processes affecting the nearby tissue that weaken the eyelid structure. […] The present study identified statistically significant associations between involutional ectropion and both hypertension and dyslipidemia, suggesting that these cardiovascular risk factors may contribute to the development of paralytic ectropion. […] This study provides compelling evidence that various inflammatory conditions affecting the eyelids and the ocular surface, as well as systemic inflammatory diseases, significantly increase the risk of developing ectropion.

• #19 Ectropion – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ectropion/symptoms-causes/syc-20351164

  In ectropion, the lower lid sags away from the eye. Because of the sagging lid, your eye can’t close completely when you blink, which can cause the eye to be dry and irritated. […] Ectropion (ek-TROH-pee-on) is a condition in which your eyelid turns outward. This leaves the inner eyelid surface exposed and prone to irritation. […] Ectropion can be caused by: […] Muscle weakness. As you age, the muscles under your eyes tend to weaken, and tendons stretch out. These muscles and tendons hold your eyelid taut against your eye. When they weaken, your eyelid can begin to droop. […] Facial paralysis. Certain conditions, such as Bell’s palsy, and certain types of tumors can paralyze facial nerves and muscles. Facial paralysis that affects eyelid muscles can lead to ectropion. […] Scars or previous surgeries. Skin that has been damaged by burns or trauma, such as a dog bite, can affect the way that your eyelid rests against your eye. Previous eyelid surgery (blepharoplasty) can cause ectropion, particularly if a considerable amount of skin was removed from the eyelid at the time of surgery. […] Ectropion leaves your cornea irritated and exposed, making it more susceptible to drying. The result can be abrasions and ulcers on the cornea, which can threaten your vision.

• #20 Ectropion: Causes, Symptoms, and Complications

  https://www.healthline.com/health/ectropion

  Ectropion (ek-TROH-pee-on) is when your lower eyelid turns or sags outward, away from your eye, exposing the surface of your inner eyelid. […] The primary cause of ectropion is muscle weakness or tissue relaxation that occurs as part of the normal aging process. Your risk of developing ectropion increases with age. […] Long-term irritation, excessive dryness, and exposure of the cornea can lead to conjunctivitis, or infection of the eye. This can result in infected pus or fluid around your eye and on your eyelashes, especially when you wake up in the morning.

• #21

  https://journals.lww.com/ijo/fulltext/2006/54030/acute_idiopathic_bilateral_lower_lid_ectropion.24.aspx

  Lower-eyelid tarsal ectropion is an unusual form of eyelid malposition, in which the entire lid is everted. The cause is disinsertion of the lower-eyelid retractors. Patients with ectropion have larger-than-average tarsal plates for their ages. Ectropion results from normal or larger-than-normal tarsal plate vector forces, mechanically overcoming the normal or decreased tone of the preseptal/pretarsal orbicularis muscle, in combination with medial/lateral canthal tendon laxity. […] Racial variations in the bony architecture of the lower rim are recognized. Black patients have less prominent malar bones and the inferior orbital rim is posterior in relation to the eyeball. These patients have less support for the lower lid, which may predispose to lower lid retraction or ectropion. […] In addition to demonstrating malar hypoplasia, our patient had a larger tarsal plate and probably inherent retractor weakness. These features should be considered as a cause of acute onset of ectropion in young patients.

• #22 Arquivos Brasileiros de Oftalmologia – Eyelid aging: pathophysiology and clinical management

  https://www.aboonline.org.br/details/2117/en-US/eyelid-aging–pathophysiology-and-clinical-management

  Ultrastructural changes in the elastic fibers of the eyelid in patients suffering from involutional ectropion and entropion may result from a primary defect in the formation of elastin or from the secondary enzymatic degradation of properly formed fibers. […] Aging skin is characterized by increasing laxity and decreasing numbers of collagen and elastic fibers. […] Collagen and elastic fibers are essential components of the extracellular matrix of the eyelid and are responsible for its function.

• #23 Effect of Sleep Position on the Development of Ectropion or Entro

  https://www.longdom.org/open-access/effect-of-sleep-position-on-the-development-of-ectropion-or-entropion-in-aged-population-44667.html

  Another possible theory to explain the association between preferred sleep position and the development of unilateral ectropion is the mechanical pressure theory. […] Thus, these studies support the hypothesized mechanical pathogenesis: the position of the head, when lying on a given side, may cause the outward turning of the eyelid and, in the long run, the possible development of ectropion. […] Our study firstly demonstrates the association between sleep position preference and the risk of developing an ectropion.

• #24 Effect of Sleep Position on the Development of Ectropion or Entro

  https://www.longdom.org/open-access/effect-of-sleep-position-on-the-development-of-ectropion-or-entropion-in-aged-population-44667.html

  The pathogenesis of both diseases includes increased horizontal lid laxity, age-related atrophy of the orbital fat and relaxation of ligamentous support. […] Since the laxity of the eyelid is the pathophysiological basis for ectropion and entropion, a correlation between those conditions and their development seems logical. […] The hypothesis of the study is that prolonged sleeping on one side increases the risk for the development of involutional ectropion or entropion. […] Tissue hypoxia may play a role in the development of eyelid malposition. During sleep time, transient and relative tissue hypoxia could develop due to direct pressure exerted on the eyelid. […] The primary pathology of both involutional ectropion and FES is lid laxity. […] The difference we have found in the correlation between the preferred sleep side and the morbidity between the two groups may stems from the fact that hypoxia is more dominant in the pathophysiology of ectropion than entropion.

• #25 Entropion And Ectropion

  https://www.eophtha.com/posts/entropion-and-ectropion

  Ectropion is an eyelid malposition in which the eyelid margin does not oppose the globe. […] Horizontal eyelid laxity as well as vertical foreshortening of the anterior lamella (skin and orbicularis muscle) play a role in development of ectropion. […] A scarred and vertically shortened anterior lamella can lead to outward turning of the eyelid due to an imbalance of forces.

• #26 3-Step Combined Technique for Correction of Involutional Lower Eyelid Ectropion: A Case Series

  https://www.mdpi.com/2077-0383/14/1/128

  Prolonged exposure may result in fibrosis and scarring, perpetuating the lid malposition. This cascade of events underscores the complex interplay of factors contributing to involutional ectropion. […] The increase in the horizontal length of the eyelid is recognized as the primary factor in the pathogenesis of involutional lower eyelid ectropion. This elongation contributes to the loss of contact between the eyelid and the eyeball, ultimately allowing the eyelid to rotate outward, which results in ectropion. […] The upward and inward tension generated by shortening the eyelid is instrumental in counteracting both vertical descent and horizontal eversion, thereby restoring the lower eyelid’s natural position and function. […] The second crucial step of our technique involves releasing the lower eyelid skin to mitigate the out-pulling vector caused by secondary inflammatory changes in the eyelid skin. Chronic epiphora, a common consequence of longstanding ectropion, often induces inflammation and subsequent contracture of the lower eyelid skin, exacerbating the lower lid malposition. […] The last step of our combined procedure therefore consists of the transposition of a laterally based myocutaneous flap from the upper eyelid to cover the skin deficit resulting from the previous step and stabilize the eyelid position.

• #27 GMS | GMS Ophthalmology Cases – An Open Access Journal | Congenital upper eyelids ectropion in Down’s syndrome

  https://www.egms.de/en/journals/oc/2017-7/oc000054.shtml

  Congenital bilateral ectropion of the upper eyelids is a rare, benign condition reported in ophthalmic literature. […] Its etiology is unknown and several possible mechanisms have been proposed, however it is frequently associated with Downs syndrome, ichthyosis, and newborns in the black population. […] We will discuss the mechanism of the eyelid ectropion and its management. […] Although the physiopathology of congenital upper eyelid ectropion is unknown, multiple factors have been implied, including absence of an effective lateral canthal ligaments, lateral elongation of the eyelid, hypotonia of the orbicularis, vertical shortening of the anterior lamella, and failure of the orbital septum to fuse with the levator aponeurosis. […] We believe that correct management to the congenital ectropion upper eyelid in these cases should include the correction of the underlying anterior lamella shortening with full-thickness skin grafts that should be extended beyond the horizontal limb of the canthal tendon to compensate for subsequent contraction of the graft. […] In conclusion, congenital ectropion of the upper eyelid is a rare abnormality that can threaten the cornea and visual acuity if not treated early.

• #28 Ectropion: Symptoms, Causes, and Treatment

  https://resources.healthgrades.com/right-care/eye-health/ectropion

  Ectropion of both upper eyelids is rare but more frequent in people born with Down syndrome. […] Treatment may vary based on the diagnosis and exam results. There are also two goals of treatment: symptom relief and ectropion repair. […] Surgery to repair ectropion is a common treatment, but recurrence is possible after several years, according to the American Academy of Ophthalmology (AAO). […] The AAO classifies ectropion into four types based on the direct cause: Involutional ectropion, Cicatricial ectropion, Paralytic ectropion, Mechanical ectropion. […] Without treatment, possible complications include: vision loss, eye pain and injury, corneal abrasions and ulcers, conjunctivitis, also known as pink eye. […] Ectropion requires prompt medical care to prevent infection and vision loss. Surgery is often successful and resolves symptoms. […] Ectropion causes eyelids to pull away from the eye. Left untreated, eye exposure can lead to vision issues and infection.

• #29 Involutional ectropion

  https://webeye.ophth.uiowa.edu/eyeforum/cases/218-ectropion.htm

  Understanding eyelid anatomy is helpful when planning surgical repair. […] The primary modality for repair is the lateral tarsal strip which is the most direct way to address horizontal eyelid laxity. […] It is well understood that using a combination of these procedures, when indicated, is a fantastic way to achieve excellent functional and aesthetic outcomes. […] The severity of ectropion determines which procedure or combination of procedures should be employed. […] Cicatricial ectropion is usually associated with shortening of the anterior lamellae. […] Mechanical ectropion refers to a situation in which a mass on the lower lid is pulling it down/away from the globe. […] Although lower lid malposition associated with facial paralysis has been classically described as an ectropion, many surgeons now recognize this malposition as a retraction due to the unopposed action of the lower lid retractors. […] Congenital ectropion is a rare condition usually affecting the upper eyelid.

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