One of the diseases that can greatly harm the eyes is eversion of the eyelid. This is not only not very aesthetically pleasing, but can also lead to dangerous consequences. In the article, we will consider what an eversion of the eyelids (ectropion) is and what it arises from.
What is this
Exposure of the conjunctiva, eversion and separation of the edge of the eyelid attached to the eyeball is a pathology called ectropion.
An exacerbated stage of the disease is detected with abundant release of tears, blinking frequency, overflow of blood vessels of the skin with the subsequent development of ophthalmic diseases: inflammation and clouding of the cornea and mucous composition of the eyes. This disease is equally characteristic of both men and women, but the elderly are most susceptible to it.
Causes of occurrence
Violation of the sensitivity of the skin and a decrease in the natural properties of the eye circular muscles more often contributes to the development of eversion of the eyelid. A disease appears when the fiber under the skin atrophies, and at the same time occurs during inflammatory processes of blepharitis andconjunctivitis spasms in the periorbital muscles. Eye diseases are accompanied by reduced blood circulation in the cerebral cortex, leading to disturbances in the supply of nerve tissues and facial muscles. Due to the loss of tone, the edge of the eyelid separates and turns outwards.
There are causes of etiological properties, occurring due to a cut and paralysis of the nerve of the face. A congenital anomaly occurs in embryonic development.
There are other reasons for eversion of the eyelid:
- blepharoplasty;
- for genomic pathologies (Down syndrome);
- from blepharophimosis;
- from focal dermal hypoplasia;
- with craniofacial development;
- from a hereditary skin disease (lamellar ichthyosis);
- with rare genetic disorders (Miller's syndrome), with defects and pathologies of the physical structure of the body;
- for chronic skin disease (permanent lupus erythematosus);
- for chronic diseases accompanied by impaired connective tissue (scleroderma);
- diffuse inflammatory pathologies of connective tissue (dermatomyositis);
- tuberculous periostitis of the edges of the orbit;
- infectious disease (actinomycosis);
- formation of tumors;
- burns and facial injuries;
- after surgery and implants in the facial area.
Disease symptoms
Symptoms of the disease are characterized by the forms of occurrence.
They are subdivided as follows:
- mechanical;
- congenital;
- paralytic;
- scar;
- senile.
For all forms of the disease, including upper eyelid eversion, the main symptoms are:
- constant shedding of tears;
- increased blink rate;
- separation of cells in the integument of the skin and overflow of blood vessels with blood.
Also, the palpebral part of the conjunctiva undergoes a process of keratinization, followed by displacement and deformation of the pathways for the release of tear fluid.
Common symptoms include sensations of the presence of foreign bodies or sand with a burning sensation in the eyes. As a result, blinking becomes more frequent, during which an attempt is made to mechanically remove the uncomfortable state, then the introduced infections join.
In the senile form, the disease progresses clinically, starting with an incomplete fit of the eyelids to the eyes, which is diagnosed as a partial eversion, and then progresses to the final eversion of the eyelid. Aggravate the disease attempts to remove tear secretions.
Due to cicatricial disease, disturbances occur when the eyelid closes, which contributes to the development of dystrophic and erosive lesions of the cornea.
A separate process is a disease of the paralytic form, which is manifested by drooping of the eyebrow, a clinical violation of the symmetry of the cheeks and lips, and damage to the facial muscles.
Complications of the disease
Diseases are characterized by pathological complications, which are oftencause not only cosmetic discomfort, but also turn into an acute form of the disease.
Due to the lagging of the ciliary layers, an abundant release of tears is formed, which penetrate the oral and nasal cavities, thereby causing discomfort and a decrease in efficiency. Attempts to remove persistent lacrimation introduce infections that worsen the already difficult condition of the patient.
When eversion of the lower eyelid, redness that cannot be eliminated appears. With all types of disease, vision deteriorates, susceptibility to inflammatory processes in the cornea increases with complete loss of vision, degeneration and dystrophy of the cornea occur.
Methods used in treatment
Earlier in the early nineteenth century, ophthalmologists from Germany introduced a surgical treatment technique called reconstructive blepharoplasty. This is a surgical intervention that corrects the pathology by strengthening the muscular apparatus, or restores the reconstruction of the face with the help of a skin flap.
In case of paralytic eversion of the eyelid, surgery is prescribed only in case of a complete cure for concomitant diseases.
Surgical intervention in the form of blepharoplasty is generally a safe method of correcting pathology. But, unfortunately, it is impossible to exclude cases when the consequences after surgery have early and late complications that can occur within a few days orseveral months.
Medicine treatment is prescribed only in cases of minor manifestations of the disease, or when the operation is contraindicated for the patient. From the resulting dryness in the connective membranes of the eyes, gels and drops with a moisturizing effect are prescribed.
Early complications
Early complications of treatment after eyelid eversion blepharoplasty include:
- Edema that does not go away after the standard weekly time. Puffiness is considered natural, which lasts up to a week, but with a gradual decrease. In cases of prolonged edema, the patient experiences headaches, itching around the eyes, blurred vision, blurred focus. Skin overhangs over and under the eyes are also formed with a change in color. To get rid of edema, decongestants are used, and in cases where microorganisms are introduced into the wounds, antibacterial drugs are used.
- Formation of subcutaneous hematomas. This is dangerous because they can form subcutaneous nodes and seal the eyelids. They arise from damage to blood vessels, where blood accumulates, which is removed by incisions, or when a large vessel ruptures, the situation is corrected by sewing it up.
- Occurrence of a retrobulbar hematoma. With such a dangerous complication, one of the large vessels ruptures, which is located behind the eyeball. Due to damage behind the eye, blood accumulates, from which the patient experiences sensations of fullness and pain in the head, protrusion of the eye. With such symptoms, acute glaucoma and retinal thrombosis can develop. In such cases, immediate medical attention is required.and may need surgery.
- Infection in wounds after or during surgery. After infection, the patient's sutures fester, redness, itching and swelling occur. Antibiotics are prescribed for treatment.
- Surgical removal of excess skin or hernias that contribute to the formation of eversion of the lower eyelid after blepharoplasty. In this case, light massages and gymnastics for the eyelids are prescribed to maintain the tone of the periorbital muscle. If the exercises do not give the desired result, a second operation is performed.
Late complications
Late complications after surgery are as follows:
- Dry eyes. This symptom occurs if the lacrimal gland is damaged during the operation or too much skin is removed. In the first case, eye drops with a moisturizing effect are used, in the second case, a second operation.
- Profuse lacrimation. To eliminate such a symptom, probing of the ducts is used to expand them through surgery.
- Formation of a cyst in the eyelid. Cysts form at the suture lines and may resolve on their own.
- Postoperative asymmetry of eye incisions due to poor quality suturing or scarring of the wound. Asymmetry can be corrected by a second operation.
- The appearance of sensations of poorly moistened eyes during repeated blepharoplasty. At the same time, when the eyelids close, local dryness and an increase in temperature in the eyes are felt. In this case, surgery and antibiotics are used.
- The occurrence of postoperative scars. They can be removed non-surgical through acid peels or laser resurfacing.
Also, a situation may arise when the seams diverge due to accidental injuries or poor-quality imposition. In such cases, the wounds are treated and resutured, but scars may form.
Restrictions after surgery
After any operation, there are limitations that must be observed, and lower eyelid eversion blepharoplasty is no exception.
Tips for the postoperative period are as follows:
- be sure to follow all the recommendations of the surgeon;
- refuse to visit the bathhouse, sauna and solarium for a month;
- avoid strenuous exercise;
- avoid direct sunlight by protecting the eye area with visor hats or sunglasses;
- refuse for a month or two from reading books, sitting at the computer and watching TV;
- exclude from the diet products that contribute to fluid retention in tissues;
- sleep only on your back and on a flat pillow.
Prevention
Timely surgical intervention to eliminate eyelid eversion will improve the patient's ability to work and life, since the disease has a favorable prognosis in general.
In ophthalmology, no active measures have yet been developed to prevent the disease. The only thing left for patients is an annual examination to detect an early threat.eyelid eversion.
After surgery, the patient should register with an ophthalmologist and be examined by him several times during the year.
Disease in dogs
Owners of certain dog breeds should also be aware that their pets can get ectropion.
The following breeds most often suffer from eyelid ectropion in dogs:
- Chinese Shar Pei and Chow Chow - because of the large folds of skin on the muzzle that hangs over the eyes. In addition, Shar-Pei suffer from bilateral ectropion.
- Central Asian and Caucasian Shepherd Dog - the disease provokes inbreeding of animals.
- Cane Corso - in dogs of this breed, torsion occurs along with torsion.
- Pugs and Pekingese - breeds have a feature in the form of protruding eyeballs and large folds of skin in the nose area, which provokes the onset of the disease.
Conclusion
All forms of ectropion with different clinical complications end with a positive result after surgery. If this disease is allowed to progress, it will lead to a severe deterioration of vision with a guarantee of its complete loss and disability. Therefore, if you suspect this disease, you should immediately contact a specialist.
