Ectropion
| Classification according to ICD-10 | |
|---|---|
| H02.1 | Ectropion of the eyelid |
| ICD-10 online (WHO version 2019) | |
Under Ectropion refers to an acquired deformity of the eyelid with an outward rotation. Most often this is the lower eyelid.
causes
The cause may be the reduced tension in the ring-shaped eye sphincter, which leads to the eyelid rolling outwards. This often occurs in the elderly. It is then referred to as Ectropium senile or Ectropium atonicum. This is promoted by inflammation of the edge of the eyelid and the conjunctiva or by increased wiping movements in watery eyes.
Paralysis of the eye sphincter due to facial paralysis can also be a possible cause. The ectropium is then called ectropium paralyticum. After injuries, scarring of the eyelid skin and shrinking of the scars can lead to an outward inversion of the eyelid, which is known as scar nectropion or ectropium cicatriceum.
Ectropion can also occur in the context of syndromes, congenital diseases, such as Elschnig syndrome or Barber-Say syndrome . Ectropion occurs rarely in the context of dystonia, see also Meige syndrome .
Symptoms
Due to the misalignment of the lid it comes to epiphora : tears drip on the eyelid and along possibly cheeks as they about the physiological way through the puncta in the nose - throat can not run-space because the punctum because of ectropion not rests on the eyeball. Those affected tend to wipe their tears from their eyes more often, which at most increases the misalignment.
Since the eyelid can no longer completely protect the eye, the conjunctiva in particular dries out, which can lead to conjunctivitis , especially with reddened eyes.
Diagnosis
Since the eyelid misalignment is noticeably visible, a visual diagnosis is usually sufficient. The doctor may also perform an examination with the slit lamp in order to assess the severity of conjunctivitis. Electromyography can be used to detect dystonia .
therapy
The ectropion is treated surgically. If the lower eyelid is affected, the edge of the eyelid is often included. The prognosis is good if the operation is soon, but several interventions are usually required to avoid excessive or weak correction of the position of the eyelid.
Treatment with botulinum toxin can only be useful if there is evidence of dystonia . Otherwise, ectropion can even occur as an undesirable medicinal effect when treating blepharospasm .
See also
literature
- Franz Grehn: Ophthalmology. Berlin: Springer Verlag, 30th edition, 2008, ISBN 978-3-540-75264-6
Individual evidence
- ↑ JJ Dutton: Botulinum-A toxin in the treatment of craniocervical muscle spasms: short- and long-term, local and systemic effects. Surv ophthalmol. Jul-Aug 1996; 41 (1): 51-65.
