Patient will present as → a 73-year-old male who complains of dry eyes coupled with excessive tearing. On exam, you note the conjunctiva appears red and the right eyelid is turned outward.
Ectropion (eversion of the lower eyelid) is caused by age-related tissue relaxation, cranial nerve VII palsy, and posttraumatic or postsurgical changes.
- Ectropion occurs when the eyelid turns outward, exposing the palpebral conjunctiva
- Ectropion is usually caused by muscle and ligament relaxation due to aging. It may also be caused by scar tissue from injury or previous surgery
- Tearing and symptoms of dry eyes (due to poor drainage of tears through the nasolacrimal system, which may no longer contact the eyeball)
Conjunctiva are red from air exposure and irritation.
Diagnosis is clinical (eyelid turns out)
Symptomatic treatment can include tear supplements and, at night, ocular lubricants
- Definitive treatment is surgery
Question 1 |
A 71-year-old male presents to your office complaining of dry eyes coupled with excessive tearing. On exam, the conjunctiva appears red, and the left eyelid is sagging and outward turning. What is the treatment of choice at this time?
Tear supplements and ocular lubricant | |
Immediate referral to Opthalmology to discuss surgical options Hint: This is appropriate if conservative treatments have failed or if there is concern cor corneal infection or a corneal ulcer | |
Topical antibiotic eye drops Hint: Topical antibiotic eye drops are not indicated in the treatment of ectropion | |
Topical steroid eye drops Hint: Topical steroid eye drops are not indicated in the treatment of ectropion |
Question 1 Explanation:
Symptomatic treatment can include tear supplements and, at night, ocular lubricants. Definitive treatment is surgery. Antibiotic and steroid eye drops are not indicated in the treatment of ectropion.
There is 1 question to complete.
References: Merck Manual · UpToDate
