Eyedrops and ointments can be used to manage symptoms and protect your cornea until a permanent treatment is done. Most cases of ectropion require surgery.
There are several different surgical techniques for ectropion, depending on the cause and the condition of the tissue surrounding your eyelid. Before the surgery, you'll receive a local anesthetic to numb your eye and the area around it. You may be lightly sedated using oral or intravenous (IV) medication to make you more comfortable, depending on the type of procedure you're having and whether or not the surgery is performed in an outpatient surgical clinic.
If your ectropion is caused by muscle and ligament relaxation due to aging, your surgeon will likely remove a small part of your lower eyelid at the outer edge. When the lid is sutured back together, the tendons and muscles of the lid will be tightened, causing the lid to rest properly on the eye. You'll have a few stitches on the outside corner of your eye or just below your lower eyelid. In general, this procedure is relatively simple and will be the only surgery you need.
If you have scar tissue from an injury or previous surgery, the surgeon may need to use a skin graft, taken from your upper eyelid or behind your ear, to help support the lower lid. If you have facial paralysis or significant scarring, the outcome of surgery is less predictable, and more than one procedure may be necessary before your ectropion is completely resolved.
Following your surgery, you may need to wear an eye patch for 24 hours, and then use an antibiotic and steroid ointment on your eye several times a day for one week. You may also use cold compresses periodically to decrease bruising and swelling, as well as acetaminophen (Tylenol, others) for pain. Avoid drugs containing aspirin, because they can increase the risk of bleeding.
At first your eyelid might feel tight, but as you heal it will become more comfortable. Most people say that their ectropion symptoms are relieved immediately after surgery. You will get your stitches removed about a week after your surgery, and you can expect the swelling and bruising to fade in about two weeks.
Although uncommon, bleeding and infection are possible risks of surgery. You will likely experience temporary swelling, and your lid tissues may be somewhat bruised after surgery.
Jan. 19, 2013
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