What is Ectropion?

Ectropion is an eye condition that exposes the inside of the lower eyelid. It can turn outward or sag and expose anywhere from a small section of the eye to the entire bottom portion. Blinking or closing the eye does not relieve discomfort because the upper and lower eyelids do not meet.

Ectropion is more common in the elderly than it is in younger people. The skin around the eyes naturally begin to sag, and facial muscles and tendons gradually weaken with age. However, ectropion can also be caused by a neurological condition such as a stroke or Bell’s palsy. It can be a result of injury, scarring, skin growths, skin cancer, Down syndrome, or prior eye surgeries. Continual exposure to air, light and airborne contaminants can result in pain, irritation and corneal damage.

What are the Symptoms of Ectropion?

Symptoms of ectropion depend on the severity and the cause of the condition. It can range from mild and hardly noticeable to severe and extremely uncomfortable.

Symptoms include

  • Upper and lower eyelids not joining when closed
  • Wateriness
  • Mucous discharge
  • Dryness
  • Burning sensation
  • Pain
  • Redness
  • Light sensitivity
  • Gritty or sandy feeling
  • Crusty eyelid or lashes
  • Worsening vision

Ectropion Causes

There are many potential causes of ectropion, with the first being genetics. In rare instances ectropion is congenital, meaning that it is present at birth. Often, it occurs as part of a genetic disorder, like Down syndrome for example.

In most cases of ectropion, the condition occurs later in life and is sometimes caused by another medical problem. Facial paralysis, perhaps caused by stroke or conditions like Bell’s palsy, may paralyze muscles in the eyelids and lead to ectropion. It’s also possible for tumors to paralyze muscles in the eyes. Sometimes growths on the eyelids, both cancerous and benign, can force the eyelid to pull away from the eye.

In many cases, it is not muscle paralysis which causes ectropion, but muscle weakness. The muscles and tendons all over our body become weakened and stretched as we age, but when the muscles in the eye are affected it can cause the eyelids to droop.

It’s possible for previous surgery on the eye to cause ectropion too, because scar tissue left behind may affect the way the eyelid rests on the eye. The surgery could have been performed to remove a growth on the eyelid, or to remove part of the eyelid in a procedure known as blepharoplasty. Similarly, trauma sustained to the eye during an accident could also cause scarring and lead to ectropion.

How is Ectropion Treated?

Eye lubricant or artificial tears can provide immediate relief, but surgery is required to repair ectropion. It is usually preformed under local anesthesia with a mild intravenous sedative. The method of surgical correction depends on the cause of the condition. If sagging skin or weak muscles are the reason, a small section of skin may be removed near the outer corner of the eye. When rejoined, the lower lid will fit more snugly against the eye and meet the upper eyelid when closed. When ectropion is caused by a prior surgery or scarring, a skin graft may be applied to reinforce the lower lid.

Post-surgical care may include

  • Patching the eye
  • Steroid and antibiotic ointment
  • Cold compresses to reduce skin discoloration and inflammation

Ectropion Prevention

Unfortunately, there doesn’t appear to be any way to prevent ectropion. However, it may be possible to prevent complications and prevent the condition from getting worse.

It’s important to use a suitable eye lubricant to minimize dryness in the eyes, which is very common with ectropion. If the eye is not lubricated, it can cause damage to the cornea which could permanently affect vision. Eye ointments and artificial tears can help to create a moisture barrier over the eye to keep it as healthy as possible.

Take care with the way in which you wipe the eyes. People with ectropion find that the affected eye waters much more than usual, but persistently wiping the eye can further stretch the eye muscles and tendons and could make the condition worse. It is safer to gently dab the eye from the outer corner inwards towards the nose.

Last Reviewed:
September 20, 2016
Last Updated:
December 19, 2017