About Ectropion
Ectropion is an eyelid disorder in which the lid margin — most often the lower lid — turns outward and away from the eye. The exposed inner lid and ocular surface lead to dryness, watering and a greater tendency to infection.
It is most often age-related, but can follow facial-nerve weakness, scarring or previous surgery. Treatment restores the lid to its normal position and protects the cornea.
What Is Ectropion?
In ectropion the eyelid no longer sits snugly against the globe, so tears cannot drain properly and the surface is left exposed. Paradoxically this causes both dryness and constant watering, along with chronic irritation.
Loss of eyelid tone, scarring or nerve weakness are the usual mechanisms. Definitive correction is surgical; aesthetic lid options are covered under eyelid surgery.
Symptoms
Common complaints in ectropion include:
- Dryness and irritation: The exposed surface dries out and feels gritty.
- Constant watering: Tears overflow because they cannot drain normally.
- Redness of the inner lid: The visible inner lid becomes red and inflamed.
- Tendency to infection: Exposure increases the risk of conjunctivitis.
- A sagging lower lid: The lid visibly falls away from the eye.
Causes & Risk Factors
The main causes of ectropion are:
- Involutional (age-related) ectropion: Laxity of eyelid tissues with age — the most common cause.
- Facial-nerve palsy: Weakness of the muscles that close the eye (e.g. Bell’s palsy).
- Scarring (cicatricial): Burns, trauma or surgery pull the lid outward.
- Previous eyelid surgery: Over-correction or scarring can evert the lid.
- Eyelid masses: A heavy lesion can mechanically pull the lid down.
Diagnosis
Assessment determines the cause and degree of lid eversion:
- Lid position and laxity tests: Snap-back and distraction tests assess tone.
- Facial-nerve evaluation: Eyelid closure and blink are checked.
- Ocular surface examination: The cornea is assessed for dryness and exposure.
- Tear-drainage assessment: Whether watering is from malposition or blockage.
Treatment
Surface Protection
Until surgery, lubrication and protection keep the exposed surface comfortable.
Lubrication
Artificial tears and ointments protect the exposed surface.
Night Care
Ointment and taping protect the eye overnight.
Follow-up
Regular review monitors the cornea and plans surgery.
Comfort & Surface Protection
Lid Tightening
Definitive treatment tightens and repositions the eyelid against the globe.
Planning
Lid laxity, the cause and symmetry are assessed.
Correction
The lid is tightened (e.g. tarsal strip) or scar tissue released.
Healing
The lid re-apposes to the eye; watering and dryness improve.
A Restored Lid Position
Which approach is right for you?
The plan depends on the cause and degree of eversion and on lid laxity.