2020–2021 BCSC Basic and Clinical Science Course™
7 Oculofacial Plastic and Orbital Surgery
Part II: Periocular Soft Tissues
Chapter 10: Classification of Eyelid Disorders
Congenital ectropion rarely occurs as an isolated finding. It is more often associated with BPES, Down syndrome, or ichthyosis. Congenital ectropion is caused by a vertical insufficiency of the anterior lamella of the eyelid and may give rise to chronic epiphora and exposure keratitis. Mild congenital ectropion usually requires no treatment. If the condition is severe and symptomatic, surgical correction is similar to that used for cicatricial ectropion, with vertical lengthening of the anterior lamella with full-thickness skin grafting, and, frequently, horizontal tightening of the lateral canthal tendon.
Complete eversion of the upper eyelids occasionally occurs in newborns (Fig 10-3). Possible causes include anterior lamellar inflammation or shortage, inclusion conjunctivitis, and Down syndrome. Topical lubrication and short-term patching of both eyes may be curative. Full-thickness sutures or a temporary tarsorrhaphy is used when necessary, followed by definitive repair.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.