Ectropion

This leaflet is not meant to replace the information discussed between you and your doctor, but can act as a starting point for such a discussion or as a useful reminder of the key points.

What is an ectropion?

Ectropion is the turning outwards of your lower eyelid. It can be caused by:

• old age

• regular rubbing of your eyelids

• injury

• paralysis of a facial nerve

• scar tissue from a previous injury to your lower eyelid / cheek; or

• eye drops (an allergic reaction causing chronic dermatitis).

What are the symptoms?

• An ectropion makes your eye water and become irritable.

• You may also have discharge in your affected eye.

• The skin around your eye can become sore from constant watering.

How is an ectropion treated?

Correcting an ectropion depends on how much of your eyelid has turned outwards.

Surgery involves tightening the lower eyelid, and is the only way to correct an ectropion. There are different surgical techniques for correcting an ectropion depending on the degree of lower eyelid laxity (how loose it is) and this will be decided by your surgeon on the day of your surgery.

Sometimes a skin graft to the lower eyelid may be necessary to correct an ectropion, but you will have discussed this with your doctor at your clinic appointment.

How successful is the treatment for ectropion?

Repair of the ectropion usually cures the problem. However, over time ectropion may come back and further surgery may be needed.

How will surgery help?

• Surgery should stop your eye from feeling sore and stop/improve any discharge coming from your eye.

• Your eye should also stop watering and feel more comfortable, but this may not happen for a few weeks after surgery, whilst the sutures (stitches) are still in place.

What are the complications of ectropion surgery?

• Repeated eye infections (conjunctivitis) or skin infections (cellulitis).

• The sutures (stitches) may come apart and your eyelid wound may open (wound dehiscence).

• Scarring around your eyelid.

• Asymmetry between your eyelids (eyelids may not look the same after surgery).

• Damage to eyesight, as sharp instruments are used near the eye during surgery.

Will I have an anaesthetic?

The operation is usually carried out as a day case procedure under local anaesthetic (you are awake but the area is numbed). In certain cases sedation or general anaesthetic (you are asleep for the procedure) may be needed. You will discuss this with your doctor in clinic before your surgery.

Will I have stitches?

Yes. The sutures (stitches) used for this type of surgery are usually dissolvable. In some cases, non-dissolvable sutures may be used and would need to be removed in clinic. Your surgeon will tell you what type of sutures you have had after your surgery.

Will I be able to drive myself to the hospital for my surgery?

No. Do not drive yourself to the hospital on the day of your surgery. We advise you to bring a responsible adult with you, so they can take you home afterwards.

What will happen when I arrive at the hospital?

On admission you will be greeted by your named nurse. They will ask you questions about your health and any medications you are taking. They will also explain the surgery to you again before putting an identity band on your wrist.

What happens before my surgery?

You will be seen by the ophthalmic doctor either on the ward or in the minor operations theatre, and you will be asked for your consent for surgery. Please use this time to ask any questions or raise any concerns. Remember that you can withdraw your consent for treatment at any time.

You may be asked to put on a theatre gown to protect your own clothes, and your jewellery may be covered with tape.

A nurse will put drops in your eye to numb the inside of your lower eyelid.

How long will I be in hospital?

• If you had local anaesthetic, you may be able to go home soon after surgery.

• If you had sedation, you may need to stay in hospital for a few hours.

• If you had a general anaesthetic you may need to stay overnight, depending on your social circumstances.

How will I feel afterwards?

Your eye may feel sore inside the eyelid and you may have some bruising around your lower eyelids. You will have antibiotic ointment in your eye, so your vision may be blurred for a few minutes after surgery.

What should I do when I go home?

• Do not drive until your vision is clear, preferably not until the day after your surgery.

• Do not rub your eyelids, as this could cause the sutures (stitches) to come apart. There is also a risk of developing an infection and the ectropion returning.

• Do wash your hands before putting ointment / drops in your eye.

• Do not get the sutures wet for at least two weeks.

• Do not do any heavy lifting or strenuous activities for at least two weeks.

• Do not do any activities that may involve dirt or dust getting in to your wound (such as DIY or gardening) for at least two weeks after your surgery.

Do I need a follow-up appointment?

Yes. You will be sent/given an appointment to come to the Outpatients Department.

When can I return to work?

You may be able to return to work the next day, but this will depend on the type of work that you do as well as the type of surgery you had. Please ask your surgeon on the day of your surgery for advice.

What do I do if I feel unwell at home?

If you are worried about your eye after your operation, please contact your GP for advice or contact one of the following.

• Channel Day Surgery Centre, William Harvey Hospital Ashford
  Telephone: 01233 616263

• Day Surgery, Queen Elizabeth the Queen Mother Hospital Margate
  Telephone: 01843 234499

• Ophthalmic Unit, Kent and Canterbury Hospital Canterbury
  Telephone: 01227 866493