CASE PRESENTATION
HISTORY
A 64 years old male patient presented to ophthalmology OPD with
chief complaint of (RE) watering with burning sensation with irritation
and unable to close his eye since 4 months.
Not associated with DOV,
Diplopia,
Pain,
No H/O previous foreign body, ocular trauma,
ocular surgeries,
glasses
No significant family history of eye diseases.
Systemic illness:
K/C/O Hypertension since 12 years on regular medications.
H/O Right facial Palsy 4 months back.
Patient has doing cognitive physiotherapy.
PREOP PHOTO:
ON EXAMINATION :PATIENT IS CONCIOUS, ORIENTED TO
TIME, PLACE AND PERSON
(RE) lagophthalmous with
Lower lid paralytic ectropion with
Bell’s phenomenon poor
SLIT LAMP EXAMINATION
RE LE
Vision unaided 6/24 6/18
Lid and Lacrimal LL ectropion with exposing Normal
apparatus lower palpebral
conjunctiva
Conjunctiva Congestion + Normal
Cornea Clear Clear
Sclera Normal Normal
Anterior Chamber ACND VH GRADE-III ACND VH GRADE-III
I/P N/S/S/R to L N/S/S/R to L
Lens IMC + IMC +
ON DILATATED FUNDUS EXAMINATION
DIAGNOSIS:
Right Eye Lower lid Paralytic Ectropion (Secondary to Right side
Facial nerve palsy)
MANAGEMENT
Conservative management:
1) Lubricating Eye drops and/or Eye ointments:
Carboxymethylcellulose 0.5% eyedrop to prevent corneal dryness and
irritation and/or Hydroxypropylmethylcellulose 2%w/v eye ointment at bedtime to
help close the eyelid and prevent drying during sleep.
2)Patch:
Eye patch to protect cornea fror further dryness if the eye cannot clse
completely.
Surgical management :
LL ectropion correction surgery can be done.
Medical treatment :
corticosteroids can be given to reduce inflammation and improve
facial nerve recovery.
POSTOP PHOTOS:
