Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with symptomatic cicatricial ectropion secondary to prior thermal/chemical burn injury. Chief complaints include chronic epiphora, ocular surface irritation, foreign body sensation, and nocturnal lagophthalmos. History of burn injury noted [Date/Mechanism], with progressive eyelid retraction and scarring noted over [Duration]. No prior surgical correction attempted.
Clinical Examination Findings
Ocular examination reveals cicatricial shortening of the [Upper/Lower] eyelid lamella. Significant vertical tension noted on eyelid margin with eversion of the punctum. Exposure keratopathy present with [Grade] punctate epithelial erosions. Assessment of burn scar maturity: [Hypertrophic/Contracted/Stable]. Margin-to-reflex distance (MRD) measured at [Value] mm. Bellโs phenomenon is [Intact/Absent].
Treatment Protocol
Recommended surgical intervention: Release of cicatricial contracture via Z-plasty, V-Y advancement, or full-thickness skin graft (FTSG) harvested from [Donor Site]. Intraoperative assessment for potential need for lateral canthopexy or spacer graft (e.g., hard palate or auricular cartilage) to support the lower lid. Post-operative management includes topical antibiotic/steroid ointment, aggressive ocular lubrication, and nocturnal patching.