Ectropion is the turning out of the eyelid so that the inner surface is exposed. It most often affects the lower eyelid.
Ectropion is very often caused by the aging process. The connective (supporting) tissue of the eyelid becomes weak. This causes the lid to turn out so that the side of the lower lid is no longer against the eyeball. It can also be caused by:
- A defect that occurs before birth (for example, in children with Down syndrome)
- Facial palsy
- Scar tissue from burns
- Dry, painful eyes
- Excess tearing of the eye (epiphora)
- Eyelid turns outward (downward)
- Long-term (chronic) conjunctivitis
- Redness of the lid and white part of the eye
If you have ectropion, you will most likely have excess tearing. This happens because the eye gets dry, then makes more tears. The excess tears can't get into the tear drainage duct. Therefore, they build up inside the lower lid and then spill over the edge of the lid onto the cheek.
Exams and Tests
The health care provider will make a diagnosis by doing an exam of the eyes and eyelids. Special tests are not needed most of the time.
Artificial tears (a lubricant) may ease dryness and keep the cornea moist. Ointment may be helpful when the eye can't close all of the way, such as when you are asleep. Surgery is very often effective. The surgeon will tighten the muscles that hold the eyelids in place. It may be done as outpatient surgery setting. A medicine is used to numb the area (local anesthesia) before the surgery.
The outcome very often good with treatment.
Corneal dryness and irritation may lead to:
Corneal ulcers can cause vision loss.
When to Contact a Medical Professional
Call your provider if you have symptoms of ectropion.
If you have ectropion, get emergency medical help if you have:
- Vision that is getting worse
- Sensitivity to light
- Eye redness that is getting worse quickly
Most cases are cannot be prevented. You may use artificial tears or ointments to prevent injury to the cornea.
Belliveau MJ, Vargason CW, Burkat CN, Marcet MM, Belliveau MJ, Goel S. Ectropion. American Academy of Ophthalmology Web site. Updated November 17, 2015. eyewiki.aao.org/Ectropion#Etiology. Accessed September 8, 2016.
Cahill KV, Doxanas MT. Eyelid abnormalities: ectropion, entropion, trichiasis. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 5, chap 73.
Robinson FO, Richard J, Collin O. Ectropion. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 12.7.
Yanoff M, Cameron DL. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 431.
Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.