Ectropion

Subject: Medical and Surgical Nursing II (Theory)

Overview

Ectropion is the lower margin's turning outward. Due to the lower dropping, the cornea and conjunctiva are exposed, which can lead to conjunctivitis and corneal ulcers. Mechanical causes include eyelid tumors, bulging orbital fat, or fluid buildup. Congenital, an anti-cancer treatment that disables the function of the epidermal growth factor receptor, spasmodic contraction of the muscles along the margin of the orbicularies, and other factors are among the additional causes. Clinical signs of ectropion include The primary symptom is epiphora, which is also accompanied by irritation, excessive tearing, pain, mild photophobia, difficulty blinking, the potential for corneal ulceration from exposure, and chronic conjunctivitis. Ectropion complications that affect the cornea and cause discomfort are the most severe. Damage and irritation to the cornea can cause corneal abrasion, corneal ulcers, and eye infections. Corneal ulcers can also be dangerous to vision.

Ectropion

The lower margin is turning outward at this point. Due to the lower dropping, the cornea and conjunctiva are exposed, which can lead to conjunctivitis and corneal ulcers.

Causes

  • Mechanical causes include eyelid tumors, bulging orbital fat, or fluid buildup.
  • Muscles along the edge of the orbicularies contract spasmodically.
  • Decrease of muscle tone throughout. the orbicular muscles, in particular as one ages
  • Contracture brought on by skin sores and the scars of facial burns.
  • Injury to the facial nerve
  • Lower eyelid granuloma or tumor.
  • Eye and eyelid inflammation, such as that caused by blepharitis or congenital aging
  • Epidermal growth factor receptor function-blocking anti-cancer medication.

clinical features

  • The primary symptoms include epiphora.
  • Excessive tearing, irritation, and dryness
  • Discomfort
  • Slight photophobia
  • Blinking is challenging
  • Exposure may cause a corneal ulcer to appear.
  • The conjunctiva that is exposed turns red, dry, and thick.
  • Persistent conjunctivitis

Complication

  • Ectropion complications that affect the cornea and cause discomfort are the most severe. Damage to and inflammation of the cornea may cause:
  • Corneal scratching
  • Ocular ulcer
  • Eye disease
  • A corneal ulcer might impair vision.

Nursing care

Before surgery

Nurses should demonstrate a variety of techniques for easing symptoms and discomfort. Teach the patient, as an illustration:

  • Use eyewash or cooled, boiled water to wash your eyes every day to keep them clean.
  • To lubricate the eye and soothe any discomfort, redness, or soreness, apply ointment or artificial tears.
  • Conjunctivitis is one infection that can be treated with antibiotic drops or ointment.

After surgery

  • A pad will be put over the eye after surgery to lessen swelling and bruising. Depending on the complexity of the procedure, the pad may be removed at the hospital within a few hours or the patient may be instructed to do so at home the following day.
  • Nurses should instruct the patient to take precautions to keep the area around the eye clean and free of infection after the pad has been removed. Usually, the hospital will prescribe antibiotic drops or ointment to wear for seven to ten days.
  • Encourage the patient to refrain from rubbing or applying pressure to the impacted eye. additionally to keep water from entering it.
  • Give the patient the go-ahead to skip the pool for at least three weeks following surgery.
  • Most people will require stitches in their eyelid tissue. Even though they are frequently dissolvable, they must still typically be removed at a hospital after one to two weeks.

 

 

 
Things to remember
  • Ectropion is the bottom margin's turning outward.
  • Due to the lower dropping, the cornea and conjunctiva are exposed, which can lead to conjunctivitis and ocular ulcers.
  • Mechanical causes include eyelid tumors, bulging orbital fat, or fluid buildup.
  • Congenital, an anti-cancer treatment that disables the function of the epidermal growth factor receptor, spasmodic contraction of the muscles along the margin of the orbicularies, and other factors are among the additional causes.
  • Ectropion's clinical characteristics include The primary symptom is epiphora, along with irritation, excessive tearing, discomfort, mild photophobia, difficulty blinking, the possibility of developing a corneal ulcer from exposure, and chronic conjunctivitis.
  • The most serious side effects of ectropion are irritation and damage to the cornea, which can result in corneal abrasion, corneal ulcers, infections of the eye, and vision-threatening corneal ulcers.
Questions and Answers
  1. Mechanical causes- eye lids tumors, herniated orbital fat, or extra vacation of fluid.
  2. Spasmodic contraction of the margin of the orbicularies muscles.
  3. General loss of muscular tone. E.g. orbicular muscles specially in old age
  4. Contracture due to scars of burns of the face and to ulcers of the skin.
  5. Damage to facial nerve
  6. Tumor or granuloma of the lower eyelid.
  7. Inflammation of eyelid and eye . for eg. Blepharitis
  8. Congenital
  9. Aeiging
  10. Anti cancer treatment which blocks the function epidermal growth factor receptor.
  • Epiphora is the main symptoms
  • Irritation
  • Excessive tearing
  • Excessive dryness
  • Discomfort
  • Mild photophobia
  • Difficulty in blinking
  • Corneal ulcer may develop due to exposure
  • The exposed conjunctiva becomes red , dry and thickened
  • Chronic conjunctivitis
  • Before surgery

Nurses should teach patients how to relieve symptoms and discomfort in a variety of ways. For example, instruct the patient:

  • To help keep the eye clean, clean it once a day with cooled, boiled water or eyewash.
  • To moisten the eye and relieve any irritation, redness, or soreness, apply lubricant, such as artificial tears or ointment (available on prescription from Dr.)
  • To treat an infection, such as conjunctivitis, use antibiotic drops or oint

 

  • After surgery
  • A pad will be placed over the eye after surgery to help prevent swelling and bruising. Depending on the extent of the surgery, the pad may be removed at the hospital within a few hours or the patient may be asked to remove it at home the following day.
  • After the pad is removed, nurses should teach the client how to keep the area around the eye clean and free of infection. Typically, the hospital will provide antibiotic drops or ointment to be used for 7-10 days.
  • Advise the patient to avoid rubbing or putting pressure on the affected eye. Also, to keep any water out of it.
  • Recommend that the patient refrain from swimming for at least three weeks following the operation.
  • Most people will have stitches in their eyelid tissue. They are frequently dissolvable, but they must usually be removed at a hospital after one to two weeks.

 

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