Every living organism that exists on our planet is designed in such a way as to be able to protect itself from the effects of various environmental factors. All organs in the human body have their own local defense factors, while the immune system is the body's general and most important defense mechanism. One of the main structures that protect the eyes from various injuries is the eyelids. These mobile skin folds perform many functions, and so much attention is directed to the eyelids by plastic surgeons, since age-related skin changes first appear in this area. One of the most complex diseases of the eyelids is ectropion or eversion of the eyelid.

Clinical presentation and methods of treatment of eyelid eversion

Eyelid – it is a mobile fold of skin around the eye, which has two layers. The superficial layer consists directly of the skin and the underlying muscle, with which the eyelid can move. The deep layer of the eyelid has cartilage and conjunctiva covering it. The anterior layer of the eyelid contains sebaceous glands, as well as eyelashes, which protect the eye from the penetration of various damaging agents. Eversion of the eyelid – this is a pathology that affects only the lower eyelid, which is associated with the presence in it of two times less dense cartilage than in the upper eyelid, due to which the physiological shape of this structure is maintained. When the eyelid is everted, it lags behind the eyeball, as a result of which the protective mechanisms of the eye are violated.

Inverted eyelid:

  • main causes of eyelid eversion;
  • clinical picture of eyelid eversion: what worries the patient;
  • what types of surgery are used to treat eyelid eversion.

The main causes of eversion of the eyelid

There are several main reasons leading to the occurrence of eyelid eversion:

  • age changes – in this case, eversion of the eyelid occurs in the elderly, as a result of weakening of the muscles and stretching of the skin. In this case, there is a symmetrical lesion of both lower eyelids, and over time, the severity of the pathological process increases;
  • cicatricial changes – as a result of mechanical or thermal injuries, a scar may form on the skin of the lower eyelid, which pulls the eyelid away from the eyeball. In this case, the pathological process can be one-sided, and its severity depends on the size of the formed scar;
  • facial paralysis – often occurs after injuries or incorrectly performed surgical interventions in the face, and leads to dysregulation of the muscle that maintains the normal position of the lower eyelid;
  • tumors in the eyelid area – in this case, the eversion of the eyelid occurs due to a mechanical violation of its normal position.

Clinical picture of eyelid eversion: what worries the patient

To diagnose eversion of the eyelid is quite simple, since the pathology is determined visually. There is a lag of the lower eyelid from the eyeball on one or both sides, while the conjunctiva is exposed, and the lower eyelid goes down. As a result, the patient experiences the following symptoms:

  • lacrimation – occurs as a result of a violation of the normal outflow of tears along the lacrimal stream due to a violation of the tight contact of the eyelid with the eyeball. Tears accumulate between the eye and eyelid, then simply roll over the edge;
  • The sensation of a foreign body in the eye occurs as a result of insufficient hydration of the cornea with an eyelid that does not fit snugly against the eyeball. Drying of the cornea and provokes the occurrence of such unpleasant sensations;
  • red eyes – this is the result of an inflammatory process that develops in the conjunctiva unprotected from external factors;
  • swelling and redness of the skin of the eyelid occurs as a result of lacrimation, as the patient mechanically irritates the skin while constantly wiping tears.

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What types of surgery are used to treat eyelid eversion

Treatment of ectropion or eversion of the eyelid involves surgical intervention to reconstruct the lower eyelid. To date, the following types of operations are used:

  • Relaxing incision technique a few millimeters below the rim of the eyelid: the resulting defect is closed with a full-thickness graft taken from the behind-the-ear region. The graft is fixed with interrupted sutures and a pressure bandage, which is removed about a week after the operation;
  • The use of a nasolabial flap is especially relevant for isolated defects of the lower eyelid. After extraction, the flap is rotated to the defect of the eyelid and sutured with interrupted sutures, followed by the application of a pressure bandage;
  • A donor flap from the upper eyelid is used in cases where the eversion of the eyelid is localized mainly in the outer corner of the eye.

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