One of the diseases that can seriously damage the eyes is an eversion of the eyelid. This is not only not very aesthetically pleasing, but can also lead to dangerous consequences. In the article, we consider what the eversion of the eyelids (ectropion) is and what it arises from.
What it is
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 by abundant secretion of tears, the frequency of blinking, overflow of blood vessels in the skin with the subsequent development of ophthalmic diseases: inflammation and clouding of the cornea and mucous membrane of the eyes. Such a disease is equally characteristic of both men and women, but the elderly are most exposed to it.
Causes of occurrence
Violation of the sensitivity of the skin and a decrease in the natural properties of the ocular circular muscles more often contributes to the development of eversion of the eyelid. A disease appears when fiber atrophies under the skin, and spasm in the periorbital muscles occurs during inflammatory processes of blepharitis and conjunctivitis. Eye diseases are accompanied by decreased blood circulation in the cerebral cortex, leading to disturbances in the supply of nerve tissues and facial muscles. In connection with the loss of tone, the separation of the edge of the eyelid and eversion occurs.
There are etiological causes due to cuts and paralysis of the facial nerve. Congenital anomaly occurs in embryonic development.
There are other reasons leading to the eversion of the century:
- blepharoplasty;
- with 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;
- with chronic skin disease (persistent lupus erythematosus);
- in chronic diseases accompanied by a violation of connective tissue (scleroderma);
- diffuse inflammatory pathologies of connective tissue (dermatomyositis);
- tuberculous periostitis of the edges of the orbit;
- infectious disease (actinomycosis);
- tumor formation;
- burns and injuries to the face;
- after surgery and implant placement in the facial area.
Symptoms of the disease
Symptoms of the disease are characterized by the forms of occurrence.
They are divided as follows:
- mechanical;
- congenital;
- paralytic;
- cicatricial;
- senile.
For all forms of the disease, including eversion of the upper eyelid, the main symptoms are:
- constant release of tears;
- increased blinking rate;
- separation of cells in the skin and overflow of blood vessels with blood.
Also, the palpebral part of the conjunctiva undergoes the process of keratinization, followed by displacement and deformation of the paths for the exit of tear fluid.
Common symptoms include sensations of the presence of foreign bodies or sand with burning in the eyes. As a result, blinking becomes more frequent, in which there is an attempt to mechanically remove the uncomfortable state, then the introduced infections join.
With a 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 passes into the final eversion of the eyelid. Attempting to remove tear secretions aggravate the disease.
Due to cicatricial disease, disorders occur when the eyelid closes, which contributes to the development of dystrophic and erosive lesions of the cornea.
A separate process is a paralytic disease, which is manifested by drooping eyebrows, 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 often cause not only cosmetic discomfort, but also turn into an acute form of the disease.
Due to lagging of the ciliary layers, an abundant discharge of tears is formed, which penetrate the oral and nasal cavities, thereby causing discomfort and a decrease in working capacity. Attempts to remove persistent lacrimation introduce infections that worsen the patient’s already difficult condition.
With an eversion of the lower eyelid, reddenings that are not amenable to elimination appear. For all types of disease, vision deteriorates greatly, susceptibility to inflammatory processes in the cornea increases with complete loss of vision, degeneration and degeneration of the cornea occur.
The methods used in the treatment
As early as the beginning of the nineteenth century, ophthalmologists from Germany introduced a technique for treating a disease based on surgical intervention, which was called reconstructive blepharoplasty. This is a surgical intervention that corrects pathology, strengthening the muscular apparatus, or restores face reconstruction with a skin flap.
With a paralytic eversion of the eyelid, surgery is prescribed only in the case of a complete cure for concomitant diseases.
Surgery in the form of blepharoplasty is basically a safe method for 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 or several months.
Medication is prescribed only in cases of minor manifestations of the disease, or when surgery is contraindicated to the patient. From the resulting dryness in the connective membranes of the eyes, gels and drops with a moisturizing effect are prescribed.
Early complications
The early complications of treatment after blepharoplasty of the eversion of the eyelid include:
- Edema that does not pass after a 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 has headaches, itching around the eyes, blurred vision, blurred focus. Skin overhangs above and below the eyes also form with a change in color. Decongestants are used to get rid of edema , and antibacterial drugs are used to infect microorganisms in wounds.
- The formation of subcutaneous hematomas. This is dangerous because they can form subcutaneous nodes and lumps of the eyelids. They arise from damage to blood vessels, where blood accumulates, which is removed by incision, or when a large vessel ruptures, the situation is corrected by suturing it.
- The appearance of retrobulbar hematoma. With such a dangerous complication, a rupture of one of the large vessels occurs, which is located behind the eyeball. Due to damage behind the eye, blood accumulates, which causes the patient to feel fullness and pain in the head, bulging eyes. With these symptoms, acute glaucoma and retinal thrombosis can develop. In such cases, immediate medical attention is required and surgery may be necessary.
- Infections in wounds after or during surgery. After infection, the patient's seams are festering, redness, itching and swelling occur. Antibiotics are prescribed for treatment.
- Surgical removal of excess skin or hernias, which contribute to the formation of an 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 proper result, a second operation is performed.
Late complications
Late complications after surgery appear as follows:
- Dry eyes. This symptom occurs if the lacrimal gland is damaged during surgery or too much skin is removed. In the first case, eye drops with a moisturizing effect are used, in the other, a repeated operation.
- Profuse lacrimation. To eliminate this symptom, sounding of the ducts is used to expand them through surgery.
- The formation of cysts in the eyelid. Cysts form on the seam lines and can pass on their own.
- Postoperative asymmetry of eye sections resulting from poor-quality suturing or scarring of the wound. The asymmetry can be corrected by repeated operation.
- The appearance of repeated blepharoplasty sensations poorly moistened eyes. At the same time, when the eyelids close, local dryness and an increase in temperature in the eyes are felt. In this case, the operation and the appointment of antibiotics are used.
- The occurrence of postoperative scars. They can be removed non-surgical using acid peeling or laser resurfacing.
A situation may also arise when seams diverge due to accidentally received injuries or poor-quality overlay. In such cases, the wounds are processed and stitched again, but scars may form.
Postoperative Restrictions
After any operation, there are limitations that must be observed, and blepharoplasty of the lower eyelid eversion is no exception.
Tips for the postoperative period are as follows:
- Be sure to follow all the recommendations of the surgeon;
- for a month to refuse visits to the baths, saunas and solarium;
- avoid heavy physical exertion;
- try not to be in direct sunlight, protecting the eye area with hats with a visor or sunglasses;
- refuse for a month or two from reading books, sitting at a computer and watching TV;
- exclude from the food products that contribute to the retention of fluid in the tissues;
- sleep only on your back and on a flat pillow.
Prevention
Timely surgical intervention to eliminate the eversion of the eyelid will improve the patient's ability to work and life, since in general the disease has a favorable prognosis.
In ophthalmology, active measures to prevent the disease have not yet been developed. The only thing left for patients is an annual examination to detect the early threat of a twisting eyelid.
After surgery, the patient should be registered with an ophthalmologist and examined several times during the year.
Dog Disease
Owners of dogs of some breeds also need to know that their pets can get an ectropion.
Most often, the following breeds suffer from the eversion of the century in dogs:
- Chinese shar pei and chow chow - due to large folds of skin on the face that hangs over the eyes. In addition, sharpei suffer from bilateral ectropion.
- Central Asian and Caucasian Shepherd Dog - the disease provokes inbreeding animal breeding.
- Cane Corso - in dogs of this breed, an eversion occurs with inversion.
- Pugs and Pekingese - breeds have a feature in the form of bulging eyeballs and large folds of skin in the nose, which provokes the onset of the disease.
Conclusion
All forms of ectropion, having different clinical complications, after surgery end with a positive result. If this disease is allowed to progress, this will lead to severe visual impairment with a guarantee of complete loss and disability. Therefore, if you suspect this disease, you should immediately consult a specialist.