Ectropion: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Ectropion?
An ophthalmologist, a doctor who treats eye diseases, usually treats ectropion. A general doctor can often diagnose it by examining your eye and may refer you to an eye specialist. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is ectropion?
Ectropion is the turning out of the eyelid so that the inner surface is exposed. It most often affects the lower eyelid.
It can happen in one or both eyelids at the same time. It is more common in older people. It is not usually serious but can be uncomfortable.
Symptoms
The main symptoms include:
- A drooping and sagging lower eyelid.
- A sore, irritated, and red eye and eyelid.
- Trouble closing your eye.
- Watery eyes.
- Dry and gritty feeling eyes.
Ectropion also makes you more likely to get eye infections such as conjunctivitis. Eyelid redness may be harder to see on brown or black skin.
If you have ectropion, you will most likely have extra tearing. This happens because the eye gets dry, then makes more tears. The extra tears cannot get into the tear drainage duct. They build up inside the lower lid and spill onto the cheek.
Causes and who gets it
Ectropion is very often caused by the aging process. The supporting tissue of the eyelid becomes weak. The lid then turns out, so the inside of the lower lid is no longer against the eyeball.
Less often, other things cause it, such as:
- Facial muscle weakness.
- Nerve problems or conditions that cause facial paralysis, like Bell's palsy.
- Scar tissue from burns or injuries.
- A lump, cyst, or tumor on the eyelid.
- Using eye drops continuously for a long time.
- A defect that occurs before birth, for example in children with Down syndrome.
Risk factors listed by eye doctors include eyelid rubbing and repeated eyelid pulling, such as with contact lens use. Past eyelid surgery and trauma are also risk factors.
How doctors diagnose it
A provider diagnoses ectropion by examining the eyes and eyelids. Special tests are not needed most of the time.
An eye doctor may pull the lid away from the eyeball to see how loose it is. The doctor may also test the strength of your facial muscles. The doctor also checks the cornea, the clear outer part at the front of the eye, for damage from dryness.
Treatment
If your symptoms are mild, you may not need treatment.
Artificial tears, which are lubricating drops, may ease dryness and keep the cornea moist. Ointment may be helpful when the eye cannot close all the way, such as when you are asleep.
Some people tape the lower and upper eyelids together to protect the cornea. An eye specialist will show you how to do this with special skin tape.
Try not to wipe or rub your eyes too much, because this can make ectropion worse. If you need to wipe your eyes, dab them gently with a clean tissue.
Surgery is the lasting treatment. Drops and taping only ease symptoms while you wait for surgery. 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 cause is 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 before the surgery.
Ectropion caused by long-term use of some eye drops may go away when the drops are stopped, if that is possible. Follow your doctor's instructions about any eye drops. The outcome is very often good with treatment.
When to see a doctor
Make an appointment with your provider if you have symptoms of ectropion. Dryness and irritation of the cornea may lead to corneal abrasions, corneal ulcers, and eye infections. Corneal ulcers can cause vision loss.
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.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can look at your eyelid, check for dryness or irritation, and refer you to an eye doctor for treatment or surgery. They can also help you follow up after treatment.
Common questions
Is ectropion serious?
It is not usually serious, but it can be uncomfortable. Dryness can lead to corneal ulcers, which can cause vision loss.
What is the main treatment for ectropion?
Surgery is the main treatment. Surgery is very often effective. Artificial tears and ointment can ease dryness in the meantime.
What causes ectropion?
Aging is the most common cause. Facial muscle weakness and scar tissue from burns or injuries can also cause it.
Can ectropion be prevented?
Most cases cannot be prevented. You may want to use artificial tears or ointments to prevent injury to the cornea, especially while you wait for a more permanent treatment.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
