McGraw and Adamson developed a grading system for ectropion following a lower lid blepharoplasty. This can be used in the initial evaluation of the patient and to monitor the condition over time. The authors are from the University of Toronto.
Parameters:
(1) lateral rounding of lower eyelid
(2) amount of sclera visible below the inferior limbus of the cornea
(3) eversion of the lower eyelid
Lateral Rounding of Lower Lid
Sclera Visible
Eversion of the Lower Eyelid
Grade
none
none to minimal
none
0
present
none to minimal
none
1
present
definite band
none
2
NA
definite band
mild; tears may pool in the inferior cul de sac
3
NA
definite band
moderate to marked with exposure of palpebral conjunctiva
4
The ectropion can be further classified as:
(1) asymptomatic
(2) symptomatic (conjunctivitis, exposure keratitis, foreign body sensation, xerophthalmia, pooling of tears)
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