The mechanism of cicatricial ectropion following chemical burns differs from involutional ectropion in that cicatricial ectropion involves:

• A Laxity of the orbital septum and lid retractors
• B Vertical shortening of the anterior lamella (skin and orbicularis) pulling lid margin outward ✓
• C Dehiscence of the lower lid capsulopalpebral fascia
• D Horizontal eyelid laxity with canthal tendon stretching

Explanation

Cicatricial ectropion is caused by vertical shortening (scarring/contracture) of the anterior lamella — skin and orbicularis oculi — pulling the eyelid margin away from the globe. This occurs in chemical burns, post-inflammatory scarring, chronic eczema, and radiation injury. Involutional (senile) ectropion results from horizontal lid laxity with medial or lateral canthal tendon laxity plus lower lid retractor dehiscence. Treatment of cicatricial ectropion requires release of vertical scar with full-thickness skin grafting (usually from retroauricular donor site) to provide vertical length, rather than horizontal tightening procedures used for involutional ectropion.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.