❖ Congenital ectropion: Surgery.

❖ Senile ectropion: Surgery is indicated. A proven procedure is to tighten the lower eyelid via a tarsal wedge resection followed by horizontal tightening of the skin.

❖ Paralytic ectropion: Depending on the severity of the disorder, artificial tear solutions, eyeglasses with an anatomic lateral protective feature, or a "watch glass" bandage (Fig. 2.9) may be sufficient to prevent desiccation of the cornea. In severe or irreversible cases, the lagophthalmos is treated surgically via a lateral tarsorrhaphy.

❖ Cicatricial ectropion: Plastic surgery is often required to correct the eyelid deformity.

Prognosis: The prognosis is favorable when the disorder is treated promptly. Sometimes several operations will be required. Surgery is more difficult where scarring is present.

— Watch glass bandage for paralytic ectropion.

— Watch glass bandage for paralytic ectropion.

Fig. 2.9 In patients with lagophthalmos resulting from facial paralysis, a watch glass bandage creates a moist chamber that protects the cornea against desiccation.

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