❖ Congenital ectropion: See Epidemiology.
❖ Senile ectropion: The palpebral ligaments and tarsus may become lax with age, causing the tarsus to sag outward (Fig. 2.8).
❖ Paralytic ectropion: This is caused by facial paralysis with resulting loss of function of the orbicularis oculi muscle that closes the eyelid.
❖ Cicatricial ectropion: Like cicatricial entropion, this form is usually a sequela of infection or injury.
Fig. 2.8 The structures supporting the eyelid are lax, causing the lower eyelid sag outward.
Symptoms and diagnostic considerations: Left untreated, incomplete closure of the eyelids can lead to symptoms associated with desiccation of the cornea including ulceration from lagophthalmos. At the same time, the eversion of the punctum causes tears to flow down across the cheek instead of draining into the nose. Wiping away the tears increases the ectropion. This results in chronic conjunctivitis and blepharitis.
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