Inverted eyelid in humans. How to remove a foreign body from the eye? Surgical removal of eversion of the lower eyelid

Severe lacrimation, the sensation of sand in the eye may be associated with the presence of extropion, which is also called "eversion of the eyelids." In this case, along with unpleasant symptoms, a noticeable defect occurs, sagging of the lower eyelid and separation of the ciliary edge from the sclera.

With advanced forms, the pathology will be visually noticeable, it refers to cosmetic defects. What leads to this unpleasant pathology? What are its causes and is it true that this seemingly harmless disease will lead to blindness?

There are a number of reasons leading to the weakening of the musculocutaneous apparatus of the eyelid, but the result is always the sagging of the ciliary edge, its departure from the eyeball.

The eyelids fit very tightly to the mucous tissue of the eye (conjunctiva), since there are lacrimal canals along their edges. Normally, a tear is always produced in a person, it moisturizes the eye and protects the conjunctiva from damage and drying out.

With the normal location of the eyelid, after the tear has washed the conjunctiva, it flows down the lacrimal canals into a special lacrimal sac, located in the inner corner of the eye. Then it moves through special passages into the nasal cavity.

If the ciliary edge does not fit tightly, then the work of the lacrimal canals is disrupted, and the tear cannot move naturally. A number of characteristic symptoms appear, and among the most formidable possible consequences is a significant decrease in visual acuity.

Pathological detachment of the ciliary edge outward from the eyeball, in which part of the conjunctiva is exposed, is commonly called "eversion of the eyelids."

The second name "extropion" this disease received due to the fact that most often this pathology affects the lower eyelid.

Is there ever an eversion of the upper eyelid?

The upper eyelid is naturally not subject to eversion, it has slightly more cartilage and in natural conditions such a pathology does not occur. Despite this, eversion of the upper eyelid (extropion) is possible after blepharoplasty, which is very rare.

The cause of the pathology will be postoperative scars or a miscalculation of the surgeon who removed too large a flap of tissue.

Upper eyelid extropion can only be treated surgically.

Types and causes of extropion

In 90 cases out of 100, an eversion of the lower eyelid is diagnosed. In this case, a number of characteristic symptoms are always found:

• Increased lacrimation, very often non-stop.
• Redness of the eyelids and conjunctiva due to constant rubbing of the eye.
• Sensation of a foreign body or sand in the eye.
• Incomplete closure of the eyelids.

If the pathology is not treated for a long time, then conjunctivitis and keratitis, thickening, and then keratinization of the tarsal (tight-fitting) conjunctiva, corneal opacity, significantly decreases visual acuity (up to blindness).

There are several types of extropion, each of them has its own way of occurrence. Often, the method of treatment will depend on the cause of the eversion. Ophthalmologists use the following classification.

Atonic (involutional) extropion

It occurs most often. It is also called senile, since it is observed in the elderly. The appearance of atonic eversion of the eyelids is correlated with the natural aging of the body, a weakening of the general muscle tone. The result of involutional processes is sagging of the skin, which provokes eversion.

With senile extropion, bilateral eversion can be observed, which increases with age. If untreated, there is a thickening of the cornea, and then its keratinization, possibly its opacity, which leads to partial blindness.

For the treatment of atonic eversion, not only surgical methods are suitable. At first, drug therapy can be used. However, this is a temporary measure and will not completely fix the problem.

You can get rid of atonic eversion with a surgical operation. During the manipulation, a part of the cartilaginous tissue is horizontally excised, which resumes the natural fit of the eyelid to the eyeball. The operation can be performed in many ways and always gives a good result.

This form refers to congenital pathology and occurs in the perinatal period, during the development of the fetus. There may be several types of congenital pathology, depending on which structures of the eyelid are undeveloped, but the treatment is always the same - surgery.

With a slight sagging and the absence of severe symptoms, the operation is not performed.

Cicatricial eversion occurs after an injury, plastic surgery on the face and eyes, eyelids, and the skin around them (blepharoplasty). Moreover, the eversion of the century after blepharoplasty occurs after several weeks or months. This is due to the fact that it will take some time for the incisions to heal and as the sutures dissolve and the scar forms, the extropion increases.

Pathology is observed from the side of scar formation.

It is very difficult to treat eversion of the eyelid after blepharoplasty, in such cases it always involves surgical intervention.

Paralytic disease

The paralytic form of extropion is usually part of an extensive paresis or paraparesis, in which the muscles of other parts of the face are affected: the lips, cheeks, and sometimes the lower and upper limbs.

Twisting and eversion of the eyelids in this case will be treated by a neurologist. After all, complex treatment of the underlying disease will be required.

Here, conservative (drug treatment) is used, usually they do not resort to surgical methods.

In the event of tumors in the orbit area, eversion of the eyelid may also occur. This pathology will arise as a manifestation of another, more complex disease, its dislocation depends on the location of the tumor.

This requires a comprehensive treatment, which will include both medication and other methods of treatment.

How to detect eversion of the eyelid?

Usually, the diagnosis of an extropion is not difficult: the patient himself can see the defect in the mirror.

When visiting a doctor, an ophthalmologist performs standard examinations:

• An external examination, which allows you to establish the presence of a decrease in the tone of the periorbital muscle, the degree of atony, swelling of the skin, the degree of non-closure of the eyelid (lagophthalmos), the presence of tumors or scars.
• Biomicroscopy, it will help to examine in more detail the conjunctiva, the edges of the eyelid, to assess in more detail the size of the pathology.
• Visometry and perimetry. These studies will assess the effect of eversion on vision quality.
• Computer keratometry to clarify the diagnosis.
• A number of laboratory tests of the eyelid scraping and some blood tests.

After the examination, the form of treatment for eversion of the eyelid is selected.

Council. Seek advice from an ophthalmological clinic that performs ophthalmic surgery. So, you don't have to do the same examinations twice.

What is blepharoplasty?

With age, human skin is stretched, and the muscular apparatus loses its flexibility. This fully applies to centuries. Most often there are skin bags under the eyes, the skin of the upper eyelids is stretched, sagging.

Blepharoplasty is a type of plastic surgery that is designed to remove age-related manifestations. However, as a result of such operations, scars can form, they provoke not only eversion of the lower eyelid, but sometimes lead to eversion of the upper one.

Correction of eversion of the eyelid after plastic surgery is quite problematic and will require high specialization of the surgeon.

However, the term blepharoplasty includes surgery to correct the eversion of the eyelid.
There are many types of surgical intervention using autoplastic or homoplastic material. To eliminate the pathology, operations are performed on Blashkovich, Kurlov, Filatov, Kolen, Kunt-Shimanovsky, Imre, Frikka. Surgeons consider this type of surgery to be uncomplicated, and usually it gives good results.

The importance of timely treatment

Inversion of the eyelid can include both medical treatment and surgical methods. The choice of the method of treatment should be carried out by an experienced ophthalmologist, since in some cases the cosmetic defect can only be corrected by a surgical method.

Ectropion of the century is congenital and acquired. In the first case, the cause is a deficiency of the skin of the lower eyelid and congenital pathologies of the eye muscles.

The following factors can lead to eversion:

• injuries and burns, as a result of which scars are formed and skin deficiency occurs;
• age-related changes (decrease in the tone of the eye muscles and elasticity of the skin, atrophy of the subcutaneous tissue);
• autoimmune diseases of the connective tissue (ichthyosis, lupus erythematosus, scleroderma);
• neoplasms in the orbit area;
• paralysis of the facial nerve, including after surgery;
• ptosis of tissues in the periorbital region.

The risk group includes patients who often suffer from inflammatory eye diseases, such as blepharitis and conjunctivitis. This increases the risk of muscle spasm.

For the elderly, bilateral lesions of the eyelids are characteristic. Without therapy, eversion will only get worse with age.

Symptoms

Inversion of the eyelid is a serious cosmetic defect, but, in addition, it is accompanied by unpleasant symptoms:

• ptosis of the lower eyelid;
• inversion of the conjunctiva outward;
• inability to completely close the eye (lagophthalmos);
• lacrimation, which occurs due to a violation of the outflow of tear fluid;
• foreign body sensation, irritation;
• frequent blinking;
• redness and puffiness of the eye;
• thickening of the eyelid margin.

Unpleasant symptoms arise from a lack of moisture in the eye. The lower part of the cornea and sclera dries up, but the outer skin of the eyelid and the inverted conjunctiva, on the contrary, are constantly washed by the lacrimal fluid, and not uniformly. Some areas remain dry.

If paralysis became the cause of eversion, then concomitant symptoms are added, namely ptosis of the eyebrows, corner of the mouth, lack of facial movements.

Lower eyelid ptosis increases the likelihood of eye infection. In this case, symptoms of purulent inflammation join. The inflammatory process can spread to the eyeball. This is fraught with atrophy of the retina and optic nerve, which will lead to loss of vision.

Classification

There are 4 types of ectropion of the eye:

• Cicatricial. This is eversion caused by damage to the mucous membrane. It occurs as a result of burns, trauma and ophthalmic diseases, which are accompanied by tissue scarring.
• Senile. This is the most common form of ptosis of the lower eyelid. It occurs due to age-related changes, namely with degenerative processes of muscle tissue. The consequence of eversion is inflammation, which, if untreated, leads to visual impairment.
• Congenital. Extremely rare. The cause is congenital shortening of the muscles or skin.
• Paralytic. It is caused by paralysis of the facial nerve, and not only the eyelid drops, but the lacrimal opening also shifts. Lacrimal fluid may not be produced at all. Paralysis is caused by a failed operation, a brain tumor, stroke, or Bell's disease.

Which doctor deals with the treatment of inversion of the lower one?

It is necessary to consult an ophthalmologist, but in most cases, eversion of the eyelid is treated surgically, so the help of a surgeon is required. Depending on the etiology of ectropion, the patient may need to consult a neurologist, oncologist and dermatologist.

Diagnostics

Diagnosis of this eye disease is not difficult. Even the patient himself can make a diagnosis by looking at himself in the mirror.

When you go to the hospital, the ophthalmologist conducts a visual examination, examines the skin around the eyes, determines the presence of complications (decreased visual acuity, infection). The main purpose of the survey is to identify the cause of the ectropion.

The doctor performs biomicroscopy, during which he not only assesses the condition of the eyelids, but also the conjunctiva, cornea and tear film.

Treatment

With eversion of the eyelid, treatment can be conservative and operative. The choice of therapy depends on the severity of the pathology.

Indications for conservative treatment:

• mild defect when there are no pronounced symptoms;
• contraindications to the operation;
• therapy of the underlying disease, which led to eversion of the eyelid (if after the treatment of the underlying pathology the ectropion is spontaneously eliminated).

In the early stages, with lagophthalmos, massage and physiotherapy exercises for the organs of vision will help. Exercise improves muscle tone. Be sure to prescribe medication, which relieves of unpleasant eye symptoms:

• for moisturizing and preventing drying out of the mucous membrane, drops of "artificial tears" are attributed -, Vizin, Okutiars;
• to eliminate the symptoms of inflammation, anti-inflammatory drops are prescribed - Indomethacin;
• when infected, antibiotics are prescribed - Levomycetin, Ofloxacin ointment, Tetracycline.

If within 6 months the ectropion could not be cured conservatively, surgery is indicated.

Indications for surgery:

• age-related changes;
• congenital ectropion;
• scars that have arisen as a result of injury or burns;
• complications after previous blepharoplasty.

In most cases, all types of eversion of the lower eyelid in humans are treated surgically with the help. The surgeon cuts the eye muscles, tightens the stretched tissue. As a result, the blinking function is restored, lagophthalmos is eliminated. The prognosis after surgery is favorable, it is possible to restore the patient's ability to work.

Treatment of paralytic ectropion is symptomatic; consultation of a neurologist is often required.

Prevention

There are no specific preventive measures. To prevent the development of ectropion, it is necessary to undergo an ophthalmologic examination once a year. The sooner an eversion is detected, the more likely the operation will be avoided.

To prevent relapse after blepharoplasty, it is worth following all the doctor's recommendations. You need to be examined every 6 months.

The drooping of the lower eyelid (with the exception of the congenital form) develops gradually over a long period. If treatment is started on time, the prognosis is favorable. Complications and surgery can be avoided.

Useful video about ectropion of the century

We perceive any imperfections in our face especially acutely, because they cannot be hidden from prying eyes under well-chosen clothes. It is even worse when such defects affect not only appearance, but also health.

Ectropion or eversion of the eyelid - this is a persistent change in its position, in which the skin edge does not come into contact with the eyeball, but is turned to the side. Diagnosis of this problem is not difficult, but treatment in most cases requires very serious.

What is it and how to bring the eyelids back to normal? Is it possible to do without surgery? What to prepare for those who decide to seek help from a plastic surgeon? the site analyzes all the nuances:

Why ectropion develops and what it looks like

In the vast majority of cases, the lower eyelid suffers - this is due to the peculiarity of its structure: the cartilaginous plate here is much thinner than the top, does not hold its shape so reliably and is easier to deform. It is extremely important to correctly establish the causes of the appearance of the defect, since the tactics of further treatment depend on this. Most often, doctors are faced with the following options:

Pathology type	Why does it arise, what features
Congenital predisposition	In this case, we are talking about the shortening of the musculocutaneous plate of the lower eyelid. This pathology is extremely rare and for the most part does not require treatment, since the defect is weak.
Senile eversion	With age, there is a prolapse of all soft tissues of the face: lower skin, subcutaneous tissue and muscles. Among other things, this process leads to the fact that the edge of the eyelid ceases to come into contact with the eyeball, and over time, the sagging of the tissues only increases.
Cicatricial deformity	As the scar matures, connective tissue tightens the skin, often resulting in a pronounced eversion of the eyelid. This happens after cuts, burns or injuries, as well as a number of operations, including.
Paralytic ectropion	It occurs with paralysis of the facial nerve, as a result of which the tone of the facial muscles of the face is lost.
Mechanical eversion	This deformation is caused by the presence of a volumetric neoplasm (tumor) in the eyelid area.
Ectropion as a symptom of another disease	It occurs, for example, in systemic lupus erythematosus, ichthyosis.
Spastic ectropion	The consequence of a spasm of the circular muscle of the eye. As a rule, it is caused by various inflammatory processes.

Disease symptoms

The defect can be mild or severe. As a rule, even in the first case, external changes are very noticeable and are accompanied by unpleasant sensations, such as watery eyes and a feeling of sand in the eyes. In more serious cases, deformity not only spoils the entire aesthetics of the face, but also causes the risk of additional complications leading to a serious deterioration in vision. According to the severity, there are:

• complete eversion;
• partial, when about a third of the century is deformed.

Symptoms in all cases are approximately the same:

• Formation of a gap or pocket between the edge of the skin and the eyeball. In this case, the mucous membrane of the inner surface of the eyelid is exposed.
• Incomplete closure of the palpebral fissure. Feels like blinking discomfort.
• Feeling of dryness, "grit" or a foreign body in the eyes. It occurs because the conjunctiva turned outward loses moisture. Over time, keratinization or ulceration of the mucous membrane may begin, which also causes considerable discomfort to the patient.
• Lachrymation. With eversion of the eyelid, the process of removing fluid through the nasolacrimal canal is disrupted. As a result, it accumulates in the corners of the eyes and flows down the cheek, like with a cold. But if in the latter case eye drops help to solve the problem, then a patient with ectropion can completely get rid of constant lacrimation only by surgery.
• Irritation and redness of the eyelid skin. The reasons are constantly emitted tear fluid, wiping it off, as well as wind, cold (frosty) air.
• Inflammation of the conjunctiva. Disruption of the natural process of cleansing the eyes of dust and microorganisms can lead to the development of inflammatory processes such as conjunctivitis.

Treatment methods

Depending on how pronounced the defect of the lower eyelid is, and the reasons that provoked its development, the doctor chooses one of the options for solving the problem:

• symptomatic treatment;
• elimination of the underlying disease, the manifestation or consequence of which was the development of ectropion;
• elimination of the defect by surgery.

Is it possible to do without surgery?

Symptomatic treatment is indicated in the following cases:

• eyelid defect is poorly expressed and does not require surgical correction;
• eversion is caused by another disease (paresis or paralysis of the facial nerve, neoplasms, etc.), the elimination of which will lead to spontaneous correction of the ectropion, and the patient only needs to reduce discomfort during the treatment period;
• full surgical correction is contraindicated for health reasons or other factors.

Medicines and procedures are prescribed that alleviate the condition of the patient with ectropion, and also help to avoid the development of complications (keratinization, ulceration or inflammation of the conjunctiva):

• Most often, these are artificial tear preparations that moisturize the mucous membrane and surface of the eyeball, which must be instilled into the eyes several times a day.
• If the eyelids do not close completely during sleep, the use of a patch is indicated to keep them in position at night.
• In severe cases where moisturizing is not enough, lid edge stitching is used to protect the conjunctiva and eye from drying out and infection.

Surgical removal of ectropion

This treatment option is indicated mainly for senile and cicatricial eversion.... Depending on the type of pathology, the patient's age, and the condition of the facial tissues, various surgical techniques can be used. To select them, the surgeon is guided by the following factors:

• the reason for the development of ectropion;
• condition of soft tissues in the eyelid area: excess or deficiency (the latter most often happens after rejuvenating blepharoplasty);
• weakness of the ligaments (cantus), which hold the corners of the eye in a certain position;
• the presence of scars and other tissue defects.

Stages of surgery to eliminate eversion of the eyelid. Removing excess skin from the outside ..:

... and from the inside:

Suturing to secure tissue in a taut position:

The appearance of the eyelid immediately after suturing:

The general essence of the operation is to transfer the deformed musculocutaneous structure of the eyelid to the correct position and fix it in it. This can be done by a plastic surgeon or an ophthalmologist surgeon in a specialized department. Preparation begins with a consultation, after which the patient will need to pass preoperative tests. Usually the list of required items includes:

• general analysis of blood and urine;
• blood clotting rate test;
• blood chemistry;
• electrocardiogram;
• x-ray examination of the chest organs.

Depending on age and health condition, additional tests and consultations of narrow specialists may be prescribed. If the intervention is planned to be performed under general anesthesia (and this is most often the case), additional consultation with an anesthesiologist will be needed.

The operation itself takes from 1 to 3 hours, depending on the chosen technique and the complexity of the case... In addition to eliminating eversion and normalizing the tear drainage process, within the framework of one intervention, it is also possible to remove hernial protrusions in the eyelid area, eliminate excess skin, raise the outer corners of the eyes - these nuances are discussed with the plastic surgeon at the consultation stage. The access incisions are located in natural skin folds and are sutured with a special cosmetic suture, so in the future the scars will be absolutely invisible.

The patient spends the first day after the operation in the clinic under the supervision of the medical staff. After discharge, you must periodically visit your doctor to monitor the tissue healing process and assess the result of the intervention.

During the first few weeks, there will be swelling and bruising around the eyelids and middle third of the face. In the first hours and days after the operation, the swelling may increase; in order to stop this process, it is recommended to apply cold compresses. To accelerate tissue recovery and resorption of puffiness, it is possible to undergo physiotherapy procedures. In order to prevent the formation of rough scars, proteolytic enzymes can be introduced.

Contraindications, possible complications, side effects

Surgical correction of ectropion is not performed in the following cases:

• diabetes;
• arterial hypertension with frequent uncontrolled crises;
• severe diseases of the cardiovascular system;
• diseases of the thyroid gland, accompanied by changes in hormonal balance;
• dry eye syndrome;
• retinal disinsertion;
• general surgical contraindications.

The most unfavorable consequence of the operation is that the defect is often not corrected by 100%. A small gap between the edge of the eyelid and the eyeball may remain. Also, there is a risk of developing a twist of the eyelid inward. Other possible complications include:

• bleeding from a wound in the first hours or days after surgery;
• divergence of seams;
• wound infection, development of inflammation;
• the development of rough scars in the eyelids;
• the development of epidermal cysts;
• disruption of the lacrimal glands;
• development of blepharoptosis and lagophthalmos.

To correct most of these complications reoperation will be required... However, the risk of their appearance can be minimized if the main restrictions are observed in the recovery period:

• refusal to visit a bath, sauna, thermal procedures on the face area - helps to avoid an increase in eyelid edema and hematomas in the first two weeks after the operation;
• protection of postoperative scars from direct sunlight and solarium radiation during the first 6 months after surgery will be an excellent prevention of the appearance of pigmentation;
• limiting physical activity, refusal to perform work in an incline within a month after the operation contributes to the speedy healing of tissues and resorption of edema.

Depending on the causes of the disease, the following forms are distinguished:

Senile eversion of the eyelid, which occurs in the elderly due to age-related weakening of the muscles and stretching of the skin, which causes sagging of the eyelids. This process, as a rule, is bilateral and only intensifies with age without treatment. This form of eversion of the eyelid can be manifested by lacrimation, inflammation, thickening and keratinization of the tarsal conjunctiva. It is corrected by surgical intervention, which consists in horizontal shortening of the lower eyelid.

Cicatricial eversion of the eyelid resulting from scarring of the skin on a post-traumatic surface due to burns and injuries, operations (blepharoplasty). Eversion of the eyelid of this form is formed gradually, its severity usually depends on the location of the scar and its size.

Paralytic eversion of the eyelid is a consequence of the complete lack of work of the facial nerve, which regulates the work of the facial muscles. Treatment of eversion of the eyelid of this form involves constant moisturizing of the eyes, with the eyelids glued during the period of therapy.

Mechanical eversion of the eyelids, usually due to the presence of various tumors located in the region of the edge of the eyelids or near them. The growth of such tumors often provokes ectropion.

Congenital eversion is the most rare form that occurs as a result of shortening of the outer lamina of the eyelid (musculocutaneous). If the eyelid maladjustment is of a low degree, surgical correction is not performed.

Symptoms

The main unpleasant symptom of eversion of the eyelids is non-stop. It occurs due to a change in the normal outflow of tears.

A tear is a product of the production of the lacrimal gland, whose excretory ducts are located under the upper eyelid, as well as several small glands that are located in the thickness of the upper (mostly) and lower eyelids. If there are no emotional reactions accompanied by abundant, then the volume of tear fluid required for metabolic processes and hydration is produced by these small glands in the eyelids. At the same time, the tear washes away, forming a kind of lacrimal trickle passing between the eyeball and the lower eyelid. Having run its way, the lacrimal stream is absorbed into certain lacrimal openings located on the inner parts of the lower and upper eyelids. Almost 90% of the tears drain at the lower lacrimal opening, and then pass into the lacrimal sac, then the nasolacrimal duct, after which moisture settles into the nasal cavity. If the eyelid loses close contact with the eyeball, the tear cannot flow down the lacrimal stream and get into the lacrimal opening. Therefore, it accumulates between the eyelid and the eye, and then simply pours over its edge.

Another disturbing symptom of ectropion is irritation of the eyelid skin, which is caused by lacrimation. The constant production of tears, plus mechanical irritation of the eyelid that occurs when trying to wipe the eye, usually leads to reddening of the eyelid skin and its swelling.

In addition, the development of the disease causes a sensation of a foreign body, or sand, in the eye. This feeling can occur when the lower eyelid is unable to close the lower part during blinking, which causes the cornea to dry out.

In severe cases, eversion of the eyelids occurs due to inflammation of the conjunctiva (mucous membrane). With this disease, despite the abundance of tears between the eye and the eyelid, the conjunctiva is open and unprotected. Due to this, it periodically dries out and gradually thickens. In addition, irritated and dry mucous membranes are an easy route for various microorganisms that cause inflammation.

Diagnostics

The patient himself in the mirror can detect a developing eversion of the eyelid. The ophthalmologist, during the examination, establishes only the cause that caused the ectropion, and gives appropriate recommendations.

Treatment of eversion of the eyelids

Senile eversion of the eyelid, as a rule, is cured only by surgery. In this case, the main task of the surgical intervention is to restore the physiological contact between the eyelid and the surface of the eye, as well as to ensure normal closing of the eyes when blinking.

The cicatricial form of eversion of the eyelid, which arose in the presence of a formed scar, is also treated only promptly.

Paralytic eversion resulting from paralysis of the facial nerve occurs during treatment by a neurologist for the restoration of the functions of the facial nerve.

Mechanical eversion due to the presence of eyelid tumors requires the primary treatment of the tumor. After that, the position of the century is already restored surgically.

For complaints of a foreign body sensation in the eye, arising in any form of ectropion, it is recommended to use eye drops to soothe and moisturize the eyes.

Blepharoplasty for the treatment of eversion of the eyelids

The wrong position of the eyelids is corrected with the help of such a type of surgical intervention as blepharoplasty. Nowadays, the eyelid is restored using autoplastic methods, in rare cases, homoplastic lyophilized material is used. Blepharoplasty is performed by several types of operations: according to Kunt-Shimanovsky, Blashkovich, Imre, Frikka, Kurlov, Filatov and Kolin.

Blepharoplasty: contraindications for surgery

Surgical treatment of eversion of the eyelid is contraindicated in patients suffering from arterial hypertension, severe cardiovascular pathologies, hypothyroidism, Graves' disease, diabetes mellitus, as well as dry eye syndrome, retinal detachment and thyroid disease.

Operation results

It is possible to assess how successfully blepharoplasty was performed 3-6 weeks after the surgery. During this time, tissue flexibility is restored, and the sutures are absorbed. Blepharoplasty usually has a longer lasting effect than other operations in the field of plastic surgery.

With the help of blepharoplasty, the weakening of skin tissues is corrected, fat hernias are eliminated, as a result of which the patient's gaze looks tired and aged. Bags under the eyes are almost completely and completely removed. The subsequent operation is performed most often no earlier than 12 years later.

Blepharoplasty: Postoperative Complications

Subject to all the rules for blepharoplasty, the risk of complications is minimal.

Potential complications may include the following conditions:

the appearance of bleeding (immediately after surgery or after several days);

divergence of seams, postoperative itching, the appearance of the effect of hot eyes;

the formation of hematomas (minor and extensive);

infection of postoperative sutures;

the appearance of postoperative scars and scars;

the development of epidermal cysts;

violation of the secretion of the lacrimal glands;

the occurrence of blepharoptosis (extremely rare);

development of lagophthalmos.

In extremely rare cases, diplopia, glaucoma and blindness can develop.

Choosing a clinic for surgery () is an important issue, since in case of an unsuccessful outcome of the operation, there may be incomplete elimination of the eversion, or, conversely, the turn of the eyelid may develop. All this requires repeated operations, increases the risk of developing cicatricial deformities. When choosing a medical institution, it is important to consider not only the cost of the operation, but also the level of specialists (an unsuccessful operation can lead not only to a relapse of the disease, but also to the appearance of cosmetic defects) and the reputation of the clinic.

The pathology of the accessory apparatus of the eye, leading to an incorrect location of the ciliary edge, is called eversion of the eyelid - ectropion. A disease affecting the lower or upper eyelid prevents it from adjoining the eyeball. As a result, it turns outward.

In the vast majority of cases, the disease affects the lower eyelid. This is due to the presence of thinner cartilage tissue. Pathological eversion of the lower or upper eyelid is possible after unsuccessful blepharoplasty.

The disease is subdivided into the following forms:

1. The most rare species is congenital. The child is born with a short musculocutaneous plate of the eyelid.
2. Spastic eversion. Circular muscle spasm caused by inflammatory disease.
3. Mechanical ectropion. The presence of neoplasms leading to eversion.
4. Cicatricial form. The impact of various external factors (burns, trauma or surgery).
5. Paralytic form. Paralysis of the facial nerves, or an unsuccessful injection of Botox.
6. Senile eversion of the upper and lower eyelids. Age-related muscle atrophy, weakening of tendons and thinning of fatty tissue.

There are two main diagnosed forms: light (the eyelid slightly moves away from the edge) and heavy (the eyelid is completely everted).

Unsuccessful blepharoplasty can cause ectropion.

Symptoms of the disease

The disease can be identified by characteristic changes in the shape of the lower eyelid. The patient has the following symptoms:

• uncontrolled lacrimation. The production of tears is carried out by the lacrimal glands, which are also located in the lower eyelid. Eversion prevents the eyelid from adjoining the eyeball, therefore, the secreted tears do not fall into the lacrimal sac, but flow out of the eyes;
• redness is observed in severe form and appears against the background of conjunctivitis. As a result of this disease, the conjunctiva is devoid of protection and is prone to drying out. Insufficiently hydrated mucosa is an excellent target for infections and inflammation;
• the sensation of a foreign body or sand in the eye causes dryness and increased irritation of the membrane;
• eroded skin area. Appears when the patient constantly rubs his eyes with his hand, or with a tissue of the upper eyelid;
• inflamed cornea. In the absence of timely treatment, blurred and deteriorated vision may appear;
• maceration of the eyelid appears due to continuous lacrimation. A permanently moist eyelid becomes less firm and elastic.

With ectropion, a secondary infection can join.

Diagnostic methods

The ectropion of the eyelid of the eye can be diagnosed independently. An examination by an ophthalmologist will help confirm the diagnosis, recognize complications, identify the cause and establish the shape.

The diagnosis is established through visual analysis and certain actions (it is enough to return the skin to the correct position to determine the scar defect).

In the paralytic form, there is no sensitivity around the eyes. To detect horizontal weakness, the doctor pulls the skin from the center of the eyelid from the eyeball by 8 mm. The skin will return to normal after blinking.

If the outer corner of the eye is pulled back by no more than 2 mm, and the palpebral fissure has a rounded shape, this indicates its weakening. With a weakened inner angle, the outwardly pulled eyelid will touch its lowest point with the limbus or pupil.

Do not confuse the inversion of the lower eyelid with the inversion of the eyelid. These are two different pathologies.

Treatment methods

In mild cases, to correct the eversion of the eyelid, treatment may consist of compresses, ointments with an antibacterial effect. To avoid infection, the eyelid is fixed in its normal position with a patch. Often these are not long-term pre-surgery measures.

Atonic volvulus is eliminated by surgery. During the procedure, the surgeon normalizes the contact of the eyelid with the eyeball and restores the eye closure during the blinking process. In a similar way, they get rid of the cicatricial form of ectropion.

Correction of eversion of the eyelid of the paralytic type must be started with the consultation of a neurologist. In the course of getting rid of neuralgia, the function of the facial nerve is restored, and then the position of the skin.

In the case of a mechanical form, they primarily get rid of the tumor, and then normalize the position of the eyelid. The feeling that a foreign object is present in the eye can be removed with eye drops prescribed by a specialist.

During surgery, the following can be used:

1. Blepharoplasty (using a laser or scalpel).
2. Surgitron apparatus. The high-frequency radio wave dissolves damaged cells without injuring the surrounding areas.

Possible complications

Mistakes made during surgery or improper further care can lead to unpleasant consequences:

• scars and scars;
• hematomas;
• bleeding;
• infection;
• itching at the site of the postoperative scar;
• disrupted work of the lacrimal gland;
• burning sensation in the eyes.

If one of the above symptoms appears, you urgently need to see an ophthalmologist.

Blepharoplasty should be performed by a professional and experienced doctor. Otherwise, complications may develop.

Traditional medicine recipes

Elderly people should be especially careful about the condition of their eyes. To do this, you can regularly do therapeutic massage and use the recipes of traditional medicine:

1. Daily exercise will help strengthen the eyelid and heal the mucous membrane: fill a container with clean water at room temperature and lower your face into it. Then open your eyes and blink quickly several times. Raise your face and blink a few more times. This manipulation is performed three times.
2. After washing your face after a night's sleep, prepare an infusion for lotions from 1 tablespoon. linden blossom and a glass of hot water. Cool the broth, moisten a double cotton pad and place on eyelids for 5 minutes.

Rehabilitation measures

In order for the rehabilitation period to pass favorably, certain indications should be observed:

• instill eye drops prescribed by a doctor;
• wear sunglasses;
• daily perform a set of gymnastic exercises for the eyes;
• use high pillows for sleeping;
• do not use contact lenses;
• eliminate bad habits and caffeine;
• limit physical activity.

During the recovery period, it is strictly forbidden to visit the bathhouse, sauna and solarium.The rehabilitation period is two months.

The symptomatology of an ectropion is similar to that of an entropion.

Forecast

Timely started treatment, surgery and compliance with the doctor's prescriptions allow you to give a favorable prognosis. The cosmetic defect will pass, sharp eyesight will return, and the patient will resume his usual lifestyle. However, in the presence of a severe pathological ocular form, a relapse is possible.

Prevention measures

To prevent the disease, you should adhere to certain rules: periodically visit an ophthalmologist, promptly eliminate inflammation, protect your eyes from mechanical damage and monitor hygiene.

If you follow preventive measures and consult a specialist at the first signs of the disease, you can avoid many problems caused by eversion of the eyelid.

Sep 25, 2017 Anastasia Tabalina