Eversion of the eyelid in humans (ectropion of the eye): forms, treatment methods and diagnosis. Everting the upper eyelid using your fingers How to evert the eyelid

One of the pathologies that negatively affects eye health is ectropion or eversion of the eyelid. Such a pathology not only harms health, but also becomes noticeable to others. Unlike figure defects, imperfections on the face cannot be hidden by clothing. This article will help you learn more about ectropion of the eyelids, the reasons for its occurrence and methods of effective treatment.

What is an eversion of the century?

Eversion of the eyelid (or ectropion) is a disease in which the position of the eyelid is disturbed when its skin edge is turned away and does not come into contact with the eyeball. This defect can affect both the upper and lower eyelids. It can appear absolutely various reasons.

It is extremely important to identify the cause of such deformation, since the choice depends on this effective methodology treatment.

Typically, the causes of eyelid inversion are associated with the following factors:

1. With mechanical eversion, the deformity is associated with the appearance of a tumor in the eyelid area. The greater the growth of the tumor, the more noticeable the inversion.
2. With congenital eversion, the defect is slightly expressed and is associated with congenital shortening of the outer musculocutaneous plate of the lower eyelid. This form of ectropion is uncommon.
3. With senile eversion, the process is associated with age-related muscle weakening and sagging skin. It is most often observed in both eyes at the same time. The result is sagging of the eyelid, which gets worse over time. The longer the disease drags on, the more noticeable it becomes externally. The pathology is accompanied by lacrimation, thickening and keratinization of the conjunctiva. With this type of ectropion, the only effective treatment is surgical treatment, which consists of horizontal truncation of the lower eyelid.
4. With spastic eversion (usually due to various inflammations) it is accompanied by spasm of the orbicularis oculi muscle.
5. For cicatricial deformation after various injuries, operations (including) or burns, accompanied by the formation of scars. This type of pathology progresses very slowly and is associated with the formation and enlargement of a scar.
6. With paralytic ectropion due to neuritis facial nerve, due to complete (or partial loss) and decreased tone of facial muscles. This form of ectropion usually affects one eye. This type of pathology resolves after the functions of the facial nerve are restored by a neurologist.
7. With symptomatic inversion, this manifestation is one of the symptoms of any systemic disease organism (ichthyosis, lupus erythematosus, etc.)

Symptoms

Eversion of the eyelid is difficult to confuse with another eye disease. Usually the patient himself notices in the mirror that his eyelid lags behind the eyeball. In addition to the fact that inversion is noticeable externally, the disease also has manifestations:

• Formation of a pocket between the eyeball and the skin edge. In this case, the inner surface of the eyelid mucosa becomes visible from the outside (looks like a bright red edging).
• Incomplete closure of the palpebral fissure. The patient notices discomfort during blinking.
• Tearing that can be non-stop. This is due to a violation of lacrimal outflow. The loss of good contact between the eyelid and the eyeball prevents the tear stream from reaching the lacrimal punctum. As a result, tears accumulate in the space between the eyelid and the eye, overflowing.
• Irritation of the skin of the diseased eyelid associated with non-stop lacrimation and mechanical irritation of the mucous membrane. These complications are associated with constant wiping of tears, redness of the eyelid and its swelling.
• Feelings of sand or foreign body in the eye. This is due to the fact that the lower eyelid does not cover the cornea when blinking, which leads to its drying out.
• Redness of the eyes due to inflammation of their mucous membrane (conjunctiva). When the eyelid is everted, the conjunctival mucosa becomes open, and the natural self-cleaning mechanism of the eyes is disrupted. Because of this, drying and gradual thickening of the conjunctiva occurs. Dry and constantly mechanically injured mucous membranes become excellent soil for the development of inflammation.

Features of the eversion of the upper eyelid

The upper eyelid is generally less prone to eversion, which is due to its anatomy, since the cartilage on the upper eyelid is twice as thick as the lower one.

Dense and powerful cartilage provides excellent protection against deformation upper eyelid.

When the upper eyelid turns outward, deformation of the ciliary edge occurs. A similar pathology of the upper eyelid is more common in older people due to weakening of the condition eye muscles. At the same time, patients feel discomfort, as well as constant feeling sand or foreign body in the eye. At the same time, the eye becomes red and irritated, the eyelid swells, and constant tearing occurs.

Vision with pathology of the upper eyelid becomes blurred. As the diagnosis worsens, keratitis develops, which can cause clouding of the corneal layer.

Features of lower eyelid inversion

The term "ectropion" is used only for the concept of inversion of the lower eyelid. Due to its anatomy, in most cases, it is the lower eyelid that inverts.

There are two degrees of lower eyelid inversion:

1. Mild: the eversion is very slight, with a slight lag and deformation of the eyelid (about a third of the entire eyelid is affected).
2. Severe: the inversion is already clearly visible above the eyelash edge. The conjunctiva of the eye is turned outward, sometimes even over the entire lower eyelid.

When the ectropion is severe, a diagnosis of spastic ectropion is often made. This pathology leads to inflammation of the mucous membrane and complications with visual impairment.

Diagnostics

The patient himself may suspect an eversion of the eyelid. To do this, it is enough to periodically examine yourself in front of the mirror. The ophthalmologist subsequently usually confirms the diagnosis, determines the cause of the disease and prescribes treatment.

Treatment

The type of treatment for ectropion is chosen by the doctor depending on the cause of the disease and its severity. Typically, all types of treatment for ectropion come down to the following methods:

• eliminating the cause of the pathology;
• symptomatic therapy;
• surgical treatment.

When surgery is not needed

Ectropion is not always treated promptly. In some cases, it is enough to get by and conservative treatment. Indications for such therapy are cases when:

• symptoms are mild;
• there are contraindications for surgical treatment (age, drug intolerance, disease);
• It is enough to eliminate the cause of the disease (tumors, paresis of the facial nerve, etc.), and ectropion will go away on its own.

The usual practice of ectropion therapy is the prescription of procedures and medications that help alleviate the patient’s condition and avoid complications of the disease (conjunctivitis, corneal ulceration, etc.). With this method of treatment, the following methods are often used:

• using a special patch at night to facilitate closing the eyes (if not closed);
• inclusion of drugs to moisturize the mucous membrane of the eyeball (usually such as artificial tears) for instillation several times a day;
• stitching the edges of the eyelids to protect them from drying out (in severe cases of the disease).

Surgical treatment of eyelid inversion

Surgical treatment is indicated mainly for the following types of ectropion:

• senile;
• cicatricial;
• mechanical (after getting rid of the tumor that caused the eyelid change).

The surgical technique is selected taking into account the patient’s age, the condition of the body and eye tissues.

The main points are:

• the reason for this inversion;
• the presence of scars;
• the degree of elasticity of the ligaments supporting the corners of the eyes.
• condition of soft tissues, their excess or deficiency (after blepharoplasty for the purpose of rejuvenation).

Surgery for ectropion is always performed by an ophthalmologist or plastic surgeon.

The essence of the operation for ectropion is to return the deformed eyelid to the correct position and fix it.

Before the operation, the patient needs to consult a surgeon and conduct a number of studies:

• blood (general, coagulation and biochemical analysis);
• urine (general analysis);
• chest x-ray.

Typically, surgery for ectropion is performed under general anesthesia, therefore, before the intervention, you need to consult an anesthesiologist.

Sometimes consultations with doctors of other specialties and additional tests may also be necessary.

Surgery for ectropion

The operation for eversion of the eyelid lasts from one to three hours, depending on the complexity and technique used. In addition to correcting the external defect, this operation normalizes the process of tear drainage and removes the cosmetic consequences of ectropion (excess skin from the eyelids is also removed, the outer corners of the eyes are raised). Such additional points are clarified in advance if the operation is performed by a plastic surgeon.

Incisions in such operations are placed in natural folds of the skin using a cosmetic suture. Subsequently, postoperative scars are completely invisible.

For several weeks after the intervention, hematomas and swelling of the eyelids and parts of the face will persist. Already in the first hours after surgery, cooling compresses are used to reduce swelling.

Inpatient observation is required on the first day of the postoperative period.

After discharge, patients are scheduled to visit the attending physician to monitor the tissue healing process.

Often for the fastest postoperative recovery and scar resorption, physiotherapeutic procedures are used (usually in combination with proteolytic enzymes).

Contraindications for surgery

Surgical treatment of ectropion has its contraindications. It is often impossible to use surgery for ectropion in older people. Also such contraindications may be serious pathologies related to:

• diseases of the heart and blood vessels;
• hypertension with frequent occurrence crises;
• complicated by diabetes mellitus;
• diseases thyroid gland severe course;
• retinal detachment;
• dry eye syndrome.

Negative consequences of the operation

Sometimes it is not possible to completely eliminate the defect with ectropion. And after the operation itself, a narrow gap remains between the eyeball and the edge of the eyelid. As a result, it remains high risk re-development gate of the century.

Common postoperative complications This disease may also have manifestations associated with:

• wound infection;
• divergence of seams;
• bleeding from a postoperative wound;
• the appearance of cysts in the epidermis;
• dysfunction of the lacrimal glands;
• blepharoptosis (drooping of the upper eyelid);
• (inability to close an eye).

An unpleasant surprise for patients is that to eliminate all of the above complications, they often have to undergo a second operation.

Memo for the patient after ectropion surgery

To minimize the risk of complications after ectropion surgery, the patient recovery period usually recommend:

• refusal of any visits to baths, saunas and generally thermal procedures on the face for 2 weeks (to reduce swelling and bruises);
• restriction of any physical activity and avoid bending over for 1 month (for successful resorption of swelling and tissue restoration);
• protection from direct sun rays eyes (including excluding visits to the solarium) for 6 months (to prevent the appearance of unnecessary pigmentation on the eye).

Any eye disease should alert you. The visual organ is not only extremely important for a full life, but also requires special attention: “Take care of your eyes like a diamond!” Eversion of the eyelid is not only a cosmetic defect, but also provokes many visual disturbances. For effective treatment of this disease, it is especially important to correctly determine the cause of its occurrence. Often, to eliminate this ocular pathology surgical treatment is required, after which it is important to comply with certain restrictions. A professionally performed operation helps eliminate all symptoms of eyelid inversion and avoid its various complications. Take care of your eyes!

Eversion of the eyelid or ectropion is a condition in which the eyelid turns outward, thereby breaking the tight contact of the eyelid with the eyeball and exposing the mucous membrane (conjunctiva).

This disease is typical only for the lower eyelid. This is explained by the fact that inside each eyelid there is dense cartilage that maintains shape and gives density, and this cartilage in the upper eyelid is twice as large as in the lower.

Under the influence of certain reasons, the eyelid can turn out, and in addition to a cosmetic defect, several symptoms appear.

Symptoms of eyelid inversion

Tearing occurs due to disruption of the normal outflow of tears.

Tear is produced by the lacrimal gland, the produced tear washes the eyeball and, forming the so-called tear duct, between the lower eyelid and the eyeball, is absorbed into the lacrimal openings on the inside of the upper and lower eyelids.

90% of the tear flows through the inferior lacrimal punctum and then through the lacrimal sac and nasolacrimal duct into the nasal cavity. Therefore, if the tight contact of the lower eyelid with the eyeball is disrupted, the tear cannot flow down the lacrimal rivulet into the lacrimal punctum and accumulates between the eye and the eyelid, and then simply rolls down over the edge of the eyelid.

Irritation skin century occurs due to lacrimation. The constant production of tears and mechanical irritation of the eyelid when trying to wipe the eye leads to the skin of the eyelid becoming red, swollen, and irritated.

Feeling of foreign body, sand may occur if the lower eyelid does not close when blinking bottom part cornea (the transparent front part outer shell eyes), because of this the cornea dries out and these unpleasant symptoms occur, in addition, irritation and redness of the eye is possible in severe cases.

Redness of the eyes may also be caused by changes in the conjunctiva (the mucous membrane that covers most of the front of the eyeball and the inner surface of the eyelids). When the eyelid is everted, despite the abundance of tears between the eyelid and the eye, the conjunctiva is open. Due to this, the conjunctiva periodically dries out, thickens over time, and various microorganisms can easily enter the open mucous membrane, causing inflammation.

Types of eversion of the eyelid.

Depending on the reason that caused the inversion, the following types are distinguished:

• Senile inversion of the eyelid - appears in older people; its cause is age-related weakening of muscles and stretching of the skin. As a rule, a bilateral process, the severity of eversion increases with age without treatment.

A

• Cicatricial eversion of the eyelid - occurs when the skin becomes scarred after injuries and burns, due to which the eyelid is pulled away from the eyeball by the scar. This type of eversion develops gradually and its severity depends on the location and size of the scar.
• Paralytic eversion of the eyelid - observed with paralysis ( complete absence work) of the facial nerve, which regulates the work of many facial muscles, including the muscle that maintains the normal position of the eyelids.
• Mechanical eversion of the eyelid is a consequence of various eyelid tumors, which can be located in or near the edge of the eyelid. With the growth of such a tumor, the tissues of the eyelid gradually grow with tumor cells, and due to the mechanical action on the eyelid, it turns out.

Diagnostics.

The patient himself, when examined in a mirror, can detect an eversion of the eyelid. During examination, the ophthalmologist determines the reason that caused the inversion and gives necessary recommendations.

Treatment.

• In senile ectropion, the main method of treating ectropion is surgery. The main goal of surgical treatment is to restore normal contact of the eyelid with the surface of the eyeball and ensure normal closure of the eyes when blinking.
• Cicatricial eversion of the eyelid, which occurs in the presence of an already formed scar, is also treated with surgery.
• Paralytic eversion - occurs when the facial nerve is paralyzed, and due to treatment by a neurologist and gradual restoration of the function of the facial nerve, the position of the eyelid is restored.
• Mechanical eversion - in the presence of a tumor of the eyelids, treatment of the tumor comes to the fore. After which the position of the eyelid is surgically restored.

In addition, if you complain of a feeling of a foreign body, sand can be used eye drops based on natural tears, which will help moisturize the eye. However, it is worth knowing that the prescription of any drug must be agreed upon in consultation with a doctor.

The term eversion of the eyelid defines its incomplete adherence to eyeball. In the literature, the name of the condition ectropion of the eyelid is also found. The pathological condition occurs in people of all ages, including children. It is most often registered in people over 45 years of age. Eversion is not only a cause of cosmetic defect and psychological discomfort, but can also lead to the development of complications, including visual impairment.

Ectropion of the lower eyelid is accompanied by the appearance of several characteristic symptoms, which include:

1. Lacrimation caused by irritation of the mucous membrane of the conjunctiva and sclera in the area of ​​incomplete closure. Also, the appearance of the symptom is due to the fact that normally in a person, tear fluid washes the eye and forms a “stream” that flows between the lower eyelid and the eye. The fluid accumulates below in the inner (medial) corner of the eye, where it is absorbed in the lacrimal openings. If there is insufficient adhesion, the tear fluid “leaks out” in the outer (lateral) angle.
2. Skin irritation resulting from systematic exposure to tear fluid against the background of increased lacrimation.
3. Subjective sensation of the presence of a foreign body in the eye (“grain of sand”).
4. Hyperemia (redness) of the conjunctiva of the eye, the appearance of (injections) of vessels on the sclera, which indicates blood stagnation and development inflammatory reaction.

The change is often accompanied by a noticeable cosmetic defect, which is characterized by a loose junction and an “everted” lower eyelid.

Reasons

The main function of the eyelids is to protect the eye from negative impact various factors environment. Due to the tight fit and blinking, uniform hydration of the eyeball is maintained. The fit is ensured by the presence of a cartilaginous frame, which to a greater extent expressed in the upper eyelid. Ectropion of the century is a polyetiological condition. This means that its development occurs due to the influence of several reasons, which include:

1. Age-related changes, which more often develop in the lower eyelid, which is associated with fewer cartilaginous structures. This is also affected by a decrease in muscle tone and a decrease in the number of elastic fibers in the skin. Age-related changes lead to the fact that over the course of long period over time, the eversion of the eyelids of both eyes gradually develops and intensifies.
2. Scar changes - the formation of connective tissue cords that have less elasticity compared to surrounding tissues after injuries (cuts, chemical or thermal burns), surgical interventions (blepharoplasty). Scars can cause the formation of not only eversion, but also volvulus.
3. Paralysis of the muscles that maintain tissue tone, which occurs as a result of impaired innervation - the condition often develops after a cerebral stroke or optic neuritis.
4. Mechanical impact – formation of tumor formation (benign or malignant tumor) in the eyelid area leads to their stretching and loose fit to the eye.
5. Systematic inflammatory processes in the structures of the eye, leading to changes in the condition of the tissues of the appendages.
6. Hereditary predisposition - the condition of the tissues, tone, and rate of destruction of the cartilaginous frame are determined by the corresponding genes, which are inherited from parents to children. This factor predetermines the development of the condition in an elderly person.

Due to anatomical features, as well as the presence of a more developed cartilaginous frame, eversion of the upper eyelid develops very rarely.

Knowing the reasons allows the doctor to choose effective treatment and preventive measures.

Diagnostics

Ectropion of the eyelid can be suspected based on the appearance of characteristic changes and clinical symptoms. The severity of changes is assessed by an ophthalmologist during an examination. It also establishes or excludes the development of relevant complications. To determine the cause of the changes, an additional examination is prescribed, which may include various methods of laboratory, instrumental and functional research.

Based on all diagnostic results pathological condition the doctor makes a conclusion and selects the most optimal treatment.

Classification

Depending on the group of reasons that led to the changes, eyelid inversion includes the following types:

1. Congenital type.
2. Post-traumatic or cicatricial eversion.
3. Age (senile) type.
4. Paralytic type (the condition is caused by a violation of the innervation of the branches of the facial nerve).

Depending on the severity of the pathological condition, lower eyelid inversion is divided into 4 degrees:

• the eversion affects only the lacrimal openings in the medial corner of the eye;
• the lower eyelid partially moves away along its entire length, and the lower strip of the sclera becomes noticeable;
• changes are characterized by the development of inflammation of the conjunctiva in the area of ​​eversion with redness of the mucous membrane and its thickening in the form of a shaft;
• eroded ectropion, accompanied by the fact that, against the background of an inflammatory reaction, small areas of integrity are formed in the conjunctiva, which long time don't heal.

Based on clinical classification The attending physician has the ability to quickly establish a diagnosis, as well as select adequate therapeutic measures.

Eversion after blepharoplasty

Blepharoplasty is surgery, the purpose of which is to change the shape of the eyelids, the shape of the eyes, and remove excess fatty tissue. After performing an operation accompanied by traumatization of a large volume of tissue, complications may develop in the form of scar formation. This can lead to loose closure, resulting in the formation of eyelid inversion after blepharoplasty. Scar complications after blepharoplasty develop relatively infrequently and require appropriate correction.

How to correct lower eyelid inversion after blepharoplasty?

The choice of therapeutic measures depends on the length of time that has passed since the blepharoplasty operation:

1. If a little time has passed after the surgical intervention and the doctor determines that there is an emerging inversion, then fixation of the eyelid with an adhesive plaster is prescribed. This makes it possible to level out the emerging changes.
2. If a lot of time has passed after the operation, then repeated surgery is prescribed. The attending physician selects the technique for correcting changes individually.

Treatment of ectropion

Correcting an inversion or ectropion of the eyelid is a complex undertaking. The choice of methodology and direction of therapeutic measures is carried out by the ophthalmologist individually. For minor changes, as well as in case the patient refuses surgery, conservative therapy. Radical treatment involves blepharoplasty - surgical correction changes in tissues.

Conservative therapy

Conservative treatment involves the appointment of several therapeutic measures:

1. The use of artificial tears eye drops, which provide sufficient hydration of the sclera and conjunctiva, as well as preventing the development of related complications.
2. The use of eye drops with antiseptic and antibacterial effects, which help prevent the development of infectious complications and reduce the severity of the inflammatory reaction.
3. Normalization functional state facial nerve with neuritis. It involves prescribing various medications pharmacological groups, the choice of which depends on the cause of nerve inflammation (anti-inflammatory, antivirals, B vitamins).

Eversion of the eyelid or ectropion is a condition in which there is a lag of the eyelid from its usual place of attachment to the eyeball, as a result of which it is “turned” outward by the mucous membrane (conjunctiva).

ICD-10 code: H02.1 Ectropion of the century

Both men and women can face this problem. Pathology can develop for a variety of reasons, and the likelihood of its occurrence increases with age.

The photo shows an inversion of the lower eyelid in an elderly man

Eversion of the eyelids is a fairly common phenomenon; in addition to inflammatory processes such as stye or abscess, it can be caused by such chronic infectious disease conjunctiva and cornea of ​​the eye, like trachoma.

It is expressed in itching, redness of the eyelids, the patient experiences the sensation of a foreign body being behind the eyelid. If left untreated, trachoma can also develop into severe form and cause eversion of the eyelids and eye injury, which is not only a cosmetic defect, but also causes severe discomfort to the patient and reduces the functionality of the visual system.

Symptoms

IN initial stages eversion there is a slight lag of the edge of the eyelid from the eyeball. In severe cases, the edge of the eyelid and almost the entire mucous membrane are turned outward; the edge of the eyelid is sometimes located at the edge of the orbit.

Lacrimation and redness of the conjunctiva due to ectropion

Eversion of the eyelids causes lacrimation (along with the eyelid, it moves away from the eye punctum), which leads to maceration of the skin of the eyelid. The inverted conjunctiva of the eyelid dries, hypertrophies and takes on the character of the epidermis.

Distinguish various degrees ectropion. Sometimes the eyelid can only loosely adhere to the eyeball; with more significant degrees of development of ectropion, the mucous membrane (conjunctiva) turns outward along its entire length or in some part of it.

Patients may experience symptoms such as:

• lacrimation;
• feeling of sand in the eyes;
• open wounds;
• redness and swelling of the eyelid;
• (inflammation of the cornea);
• maceration (wet softening).

The symptoms of ectropion vary widely, depending on the intensity of changes in the eyelid: if it is slightly drooping, as a rule, clinical signs absent or minimally manifested.

Reasons

Ectropion is characteristic of the lower eyelid. The fact is that inside the eyelids there are dense cartilages that maintain their shape. In the upper eyelids, such cartilage is twice as large as in the lower eyelids, and is therefore more resistant to deformation. Pathology of the upper eyelid can develop with poorly performed blepharoplasty.

A man with a turnout lower eyelids as a result of unsuccessful blepharoplasty

Diagnostics

Eversion of the eyelid is easy to recognize on your own. During the examination, the ophthalmologist establishes only the cause that caused the ectropion and gives appropriate recommendations.

Treatment

Treatment of ectropion always depends on its type and severity.

1. Paralytic

It may go away on its own when the cause that caused it – facial neuritis – is eliminated.

Eversion of the eyelid in a man due to paralysis of the nerve endings on the face

2. Mechanical ectropion

Treatment begins with the tumor, and then possibly surgery.

3. Senile and cicatricial ectropions

It can only be cured with surgery (blepharoplasty). The important point here is to restore the natural contact of the eyelid with the surface of the eyeball.

Pronounced eversion of the eyelid (ectropion) in an elderly patient before blepharoplasty

With a timely, adequate course of treatment, in most cases it is possible to prevent negative consequences for the eyes. In particularly severe cases, eyelid inversion after blepharoplasty cannot be completely eliminated.

Forecast

Carrying out surgical treatment Eversion of the lower eyelid provides a favorable prognosis for life and ability to work. Paralytic ectropion and all forms of the disease, complicated, are characterized by a relatively favorable prognosis.

Reducing the degree of lower eyelid inversion after blepharoplasty

Specific measures to prevent the disease in ophthalmology have not been developed. Patients are recommended to undergo an annual examination with an ophthalmologist for early detection lower eyelid eversion and purpose timely treatment. After blepharoplasty, the patient must be registered at the dispensary and visit the attending physician 2 times a year.

Complications

There is no need to be afraid that ectropion of the eyelids will have to be cured with the help of surgical intervention. As a rule, such an operation does not present any particular difficulty for the surgeon. Everything goes by pretty quickly, without further consequences and complications.

Attempts to get rid of pathology can become much more dangerous. by independent means. Firstly, the required result is unlikely to be achieved; secondly, such actions can lead to various complications, eye injuries, deterioration, and partial loss of vision.

How to prevent eyelid inversion?

Prevention of eyelid ectropion is aimed at eliminating possible factors risk of this pathological condition.

Woman with ectropion of the upper eyelid after unsuccessful blepharoplasty

1. Prevention of traumatic effects on the eye.
2. Timely diagnosis and treatment of neurological diseases.
3. Regular visits to the ophthalmologist in older people who have age-related predisposing factors.

Thus, we can conclude that any inflammatory processes, infections that affect our visual organs, as well as various injuries, burns, foreign bodies, must be treated in a timely manner, for which you should definitely seek help from a doctor.

Eversion of the eyelids is not a terrible pathology for eye diseases if treated in a timely manner.

Severe lacrimation and a feeling of sand in the eye may be associated with the presence of extropion, which is also called “eversion of the eyelids.” In this case, along with unpleasant symptoms, a noticeable defect occurs, sagging of the lower eyelid and separation of the ciliary edge from the sclera.

In advanced forms, the pathology will be noticeable visually; it refers to cosmetic defects. What leads to this unpleasant pathology? What are its causes and is it true that this seemingly harmless disease will lead to blindness?

There are a number of reasons leading to weakening of the musculocutaneous system of the eyelid, but the result is always sagging of the ciliary edge, moving away from the eyeball.

The eyelids fit very tightly to the mucous tissue of the eye (conjunctiva), since there are tear ducts along their edges. Normally, a person always produces tears; they moisturize the eye and protect the conjunctiva from damage and drying out.

In the normal position of the eyelid, after the tear has washed the conjunctiva, it flows down the lacrimal ducts into a special lacrimal sac located in the inner corner of the eye. Then it moves through special passages into the nasal cavity.

If the eyelash edge does not fit tightly, then the work tear ducts is disrupted, and the tear cannot move naturally. A number of characteristic symptoms arise, and among the most formidable possible consequences– significant decrease in visual acuity.

The pathological detachment of the ciliary edge outward from the eyeball, in which part of the conjunctiva is exposed, is commonly called “eversion.”

This disease received its second name “extropion” due to the fact that most often this pathology affects the lower eyelid.

Is there an eversion of the upper eyelid?

The upper eyelid is not naturally subject to inversion; it has slightly more cartilage and natural conditions such pathology does not occur. Despite this, inversion of the upper eyelid (extropion) is possible after undergoing blepharoplasty, which is very rare.

The cause of the pathology will be postoperative scars or a miscalculation by the surgeon who removed too large a flap of tissue.

Extropion of the upper eyelid can only be treated surgically.

Types and causes of extropion

In 90 cases out of 100, lower eyelid inversion is diagnosed. In this case, a number of characteristic symptoms are always detected:

• Increased lacrimation, very often non-stop.
• Redness of the eyelids and conjunctiva due to constant rubbing of the eye.
• Sensation of a foreign body or sand in the eye.
• Incomplete closure of eyelids.

If the pathology is not treated for a long time, then conjunctivitis and keratitis occur, thickening and then keratinization of the tarsal (tightly adjacent) conjunctiva, clouding of the cornea, and visual acuity is significantly reduced (even to the point of blindness).

There are several types of extropion, each of them has its own ways of occurrence. Often the treatment method will depend on the cause of the inversion. Ophthalmologists use the following classification.

Atonic (involutional) extropion

Occurs most often. It is also called senile, as it occurs in older people. The appearance of atonic eversion of the eyelids is correlated with the natural aging of the body and a weakening of overall muscle tone. The result of involutionary processes is sagging of the skin, which provokes eversion.

With senile extropion, bilateral inversion may be observed, which intensifies with age. If left untreated, the cornea becomes thickened, followed by keratinization and possibly clouding, which leads to partial blindness.

For the treatment of atonic ectropion, not only surgical methods. At first it can be used drug therapy. However, this is a temporary measure and will not completely eliminate the problem.

You can get rid of atonic ectropion using surgery. During the manipulation, a part of the skin-cartilaginous tissue is excised horizontally, which restores the natural fit of the eyelid to the eyeball. The operation can be performed in many ways and always gives a good result.

This form applies to congenital pathology and occurs in the perinatal period, during fetal development. There may be several types of congenital pathology, depending on which structures of the eyelid are undeveloped, but the treatment is always the same - surgery.

If the sagging is minor and there are no significant symptoms, surgery is not performed.

Cicatricial eversion occurs after an injury, plastic surgery on the face and eyes, eyelids, and the skin around them (blepharoplasty). Moreover, eyelid inversion after blepharoplasty occurs after several weeks or months. This is due to the fact that the incisions will take some time to heal and as the sutures dissolve and the scar forms, extropion increases.

Pathology is observed from the side of scar formation.

It is very difficult to treat eyelid inversion after blepharoplasty; in such cases it always involves surgical intervention.

Paralytic type of disease

The paralytic form of extropion is usually part of an extensive paresis or paraparesis, which affects the muscles of other parts of the face: lips, cheeks, and sometimes the lower and upper limbs.

In this case, inversion and eversion of the eyelids will be treated by a neurologist. After all, it will be necessary complex treatment underlying disease.

Here the conservative ( drug treatment), usually surgical methods are not resorted to.

When tumors occur in the orbital area, eyelid inversion may also occur. This pathology will arise as a manifestation of another, more complex illness, its dislocation depends on the location of the tumor.

This requires complex treatment, which will include both medications and other treatment methods.

How to detect an eversion of the eyelid?

Typically, diagnosing extropion is not difficult: the defect can be seen by the patient himself in the mirror.

When visiting a doctor, an ophthalmologist performs standard examinations:

• External examination, which allows you to determine the presence of decreased tone of the periorbital muscle, the degree of atony, swelling skin, the degree of eyelid non-closure (lagophthalmos), the presence of tumors or scars.
• Biomicroscopy will help to examine the conjunctiva, the edges of the eyelid in more detail, and assess the size of the pathology in more detail.
• Visometry and perimetry. These studies will evaluate the impact of eversion on quality of vision.
• Computer keratometry to clarify the diagnosis.
• Row laboratory research eyelid scraping and some blood tests.

After the examination, a form of treatment for eyelid inversion is selected.

Advice. Seek advice from an ophthalmology clinic that performs ophthalmological surgeries. This way, you won’t have to do the same examinations twice.

What is blepharoplasty?

With age, a person's skin stretches, and muscular apparatus loses its flexibility. This fully applies to centuries. Most often occur skin bags under the eyes, the skin of the upper eyelids stretches and sags.

Blepharoplasty is a type of plastic surgery that is designed to remove age-related signs. However, as a result of such operations, scars can form; they provoke not only inversion of the lower eyelid, but sometimes lead to inversion of the upper.

Correcting an everted eyelid after plastic surgery is quite problematic and will require a highly specialized surgeon.

However, the term blepharoplasty includes surgery to correct ectropion of the eyelid.
There are many types of surgical interventions using autoplastic or homoplastic material. To eliminate the pathology, operations are performed according to Blashkovich, Kurlov, Filatov, Kolen, Kunt-Szymanowski, Imre, Fricke. Surgeons consider this type of surgery to be uncomplicated, and it usually gives good results.

The importance of timely treatment

Eversion of the eyelid can include both medical treatment and surgical methods. The choice of treatment method should be carried out by an experienced ophthalmologist, since in some cases a cosmetic defect can only be corrected surgically.