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Etiology. When inverting, a part or all of the edges of the eyelids turn out and move away from the cornea. Causes of eyelid reversal are: 1) damage with a large tissue defect (wounds, burns, eczema, dermatitis), when the scar tissue that develops at the injury site delays the edge of the eyelid outward - cicatricial reversal; 2) diseases of the conjunctiva, when strongly edematous tissue pushes the edge of the eyelid from the eye - spastic inversion; 3) facial nerve palsy, when, due to the lack of circular muscle tone, the lower edge of the eyelid hangs and twists out - paralytic inversion appears; 4) senile atrophy of the circular muscle and flabbiness of the skin - senile eversion; In addition, the eyelid reversal may be due to neoplasms of the conjunctiva, orbit and skin of the eyelids, sometimes it is also congenital.
Clinical signs. The edge of the eyelid is not adjacent to the eyeball, and turned out. Conjunctiva according to the magnitude of the inversion is exposed, exposed to external influences and pollution. Tearing is observed, as the lacrimal point departs from the eye along with the eyelid; it is not immersed in the tear lake, the tears do not enter it and begin to overflow, wetting the skin.
This causes epithelial maceration and eczema. Conjunctiva, due to constant irritation with air, becomes inflamed and then hypertrophied. The cornea due to incomplete closure of the eyelids is irritated, infiltrated, and an ulcer may develop in it.
Forecast. For large cicatricial inversions, the prognosis is cautious to unfavorable, while minor reversals are easily treatable.
Treatment. If possible, eliminate the cause of the disease. When paralytic vyvorota prescribe treatment recommended for paralysis of the facial and oculomotor nerves: the appropriate use of massage along the nerve with rubbing irritating ointments; darsonvalization for 10–15 min daily for 2–3 weeks; faradization with an exposure of 30 minutes before the appearance of muscle contractions; diathermogalvanization, in which, during the first 10 minutes, one diathermic current of 0.5 A is given, then a galvanic current of 30 mA is applied for 20 minutes.
Cicatricial inversion can be cured by applying plastic surgery with excision of the scar. The most common and reliable operations are considered according to the methods of Dieffenbach, Szymanowski.
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