Eversion of the lower eyelid - Causes, Symptoms, Diagnosis and Treatment
Eversion of the lower eyelid - The location of the anomaly ciliary edge, which is accompanied by its separation from the eyeball and exposing the palpebral and bulbar conjunctiva. Clinically, this pathology manifests increased tearing, foreign body sensation, frequent blinking, flushing of the skin and the subsequent development of symptoms of conjunctivitis, keratitis and lagophthalmos. Diagnosis of the disease is to carry out an external inspection, visometry, biomicroscopy, perimetry, and general clinical tests. Specific treatment is eversion of the lower eyelid blepharoplasty.
Eversion of the lower eyelid
blepharitis, conjunctivitis) lead to a spasm of the periorbital muscles, increasing the risk of developing this disease. Etiologic factor of abnormal position of the lower eyelid can be paralysis or paresis of the facial nerve. Diseases associated with decreased cerebral blood flow, leading to a violation of the innervation of the facial muscles. Losing the old tone, ciliated edge is gradually separated from the orbit and turned inside out.
Congenital ectropion can act as an isolated disease, which is caused by a violation of fetal development age. Also eversion ciliary edge occurs in Down syndrome, blepharophimosis, dermal hypoplasia, cranio-fascial syndrome, lamellar ichthyosis and Miller's syndrome. This pathology is often accompanied by an autoimmune connective tissue diseases: systemic lupus erythematosus, scleroderma and dermatomyositis.
The presence of tuberculous periostitis edge of the eye socket, actinomycosis, benign and malignant tumors, burns and traumatic injuries resulting in the formation of scar that pulls the ciliary edge of the lower eyelid, and promote the development of lagophthalmos. Cicatricial ectropion may develop in patients who have undergone plastic surgery to remove skin flap large, as well as the formulation of the implant in the buccal region.
keratitis.
Paralytic ectropion is a one-way process. In addition to the clinical manifestations of eversion of the lower eyelid ptosis occurs in patients eyebrows, asymmetry of the lips and cheeks, and no facial expression on the affected side of the face. In the isolated form of congenital ectropion is often a low level of maladjustment, so the disease can occur latently or have minimal symptoms.
Ophthalmologist evaluates the function of the circular muscles. Patients with eversion of the lower eyelid is often observed decrease in tone or malnutrition periorbital muscles. It is recommended to check the degree of atony of the lower eyelid using samples from pulling down in the zone of internal and external angles. In a study of age should pay attention to the presence of benign or malignant tumors and scarring, which will establish the etiology of the disease. Also, patients rendered hyperemia and maceration of the skin. Palpable investigate the sensitivity of the periorbital area, the presence of scarring set the density and length. The patient is asked to close his eyes to identify lagophthalmos and change facial expressions to exclude paresis or paralysis of the facial nerve.
Carrying biomicroscopy eye using a slit lamp to evaluate the state of the tear film, ciliary edge of the eyelids, cornea, palpebral and bulbar conjunctiva. For a more detailed study is recommended to use biomicroscopic fluorescein, which allows you to explore the nature and size of lesions.
Visual acuity is measured by visometry. To determine the boundaries of the field of view should hold the perimeter. Additional research is needed only when the clinical picture of conjunctivitis or keratitis (computer keratometry, bacteriological seeding, scraping cytology of the conjunctiva, cornea, etc.). According to the diagnostic protocol, conducted laboratory studies (KLA, OAM, blood on RW, HBs-antigen, coagulation), but they provide little information, t. To. The specific changes in them are not observed.
blepharoplasty. Surgical correction of ectropion is to strengthen the ligament apparatus. If necessary, the reconstruction of skin graft. Patients with paralytic ectropion surgery is indicated only after the treatment of the underlying pathology.
Appointment of medication treatment it is advisable for minor manifestations of the disease or a history of contraindications to surgery. To eliminate the dryness of the conjunctiva use rewetting drops or gel. With a view to preventing the inflammatory processes are assigned NSAIDs topical (indomethacin).
Ophthalmology is not developed. Patients are advised to undergo an annual eye exams for early detection of inversion of the lower eyelid and the purpose of timely treatment. Following the blepharoplasty patient should be kept at a dispensary and physician visit 2 times a year.