Health Encyclopedia

Ectropion

Definition

Ectropion is the turning out of the eyelid so that the inner surface is exposed. It most often affects the lower eyelid.

Causes

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 inside 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 muscle weakness
Scar tissue from burns or injuries

Symptoms

Symptoms include:

Dry, painful eyes
Excess tearing of the eye (epiphora)
Eyelid turns outward (downward)
Long-term (chronic) conjunctivitis
Keratitis
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.

Treatment

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. When ectropion is related to aging or paralysis, the surgeon can tighten the muscles that hold the eyelids in place. If the condition is due to scarring of the skin, a skin graft or laser treatment may be used. The surgery is most often done in the office or at an outpatient surgery center. A medicine is used to numb the area (local anesthesia) before the surgery.

Outlook (Prognosis)

The outcome is very often good with treatment.

Possible Complications

Corneal dryness and irritation may lead to:

Corneal ulcers can cause vision loss.

When to Contact a Medical Professional

Contact your provider if you have symptoms of ectropion.

If you have ectropion, get emergency medical help if you have:

Vision that is getting worse
Pain
Sensitivity to light
Eye redness that is getting worse quickly

Prevention

Most cases cannot be prevented. You may want to use artificial tears or ointments to prevent injury to the cornea, especially if you are waiting for a more permanent treatment.

References

Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.

Maamari RN, Couch SM. Ectropion. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 12.6.

Nicoli F, Orfaniotis G, Ciudad P, et al. Correction of cicatricial ectropion using non-ablative fractional laser resurfacing. Lasers Med Sci. 2019;34(1):79-84. PMID: 30056585 pubmed.ncbi.nlm.nih.gov/30056585/.

Olitsky SE, Marsh JM. Abnormalities of the lids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 642.

Ramesh S. Entropion/Ectropion. Foundational Papers in Oculoplastics 183-196. Springer, Cham. link.springer.com/chapter/10.1007/978-3-030-92794-3_20. Published January 31, 2022. Accessed October 27, 2022.

Review Date:8/22/2022
Reviewed By:Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.