An ectropion occurs when the lower eyelid turns outward, exposing the inner eye surface. Ectropion is most common in older adults, but it can also affect younger people due to a variety of factors. It can cause irritation, dryness, and infection of the eye, along with impaired vision.
Ectropion can be caused by several factors, such as:
Aging. As the muscles and tendons that support the eyelid weaken over time, the eyelid may sag and droop away from the eye.
Facial paralysis. Conditions that affect the facial nerves and muscles, such as Bell’s palsy or stroke, can prevent the eyelid from closing properly and cause it to turn outward.
Scarring or injury. Burns, trauma, surgery, or radiation can damage the skin and tissue around the eyelid, making it tight and pulling it away from the eye.
Eyelid growths. Benign or malignant tumors on the eyelid can distort its shape and position, causing it to turn outward.
The main symptom of ectropion is a sagging or outwardly turned lower eyelid. This can lead to other symptoms, such as:
Watery eyes. The tears that normally lubricate the eye cannot drain properly into the tear ducts, and may overflow from the eyelid.
Dry eyes. The exposed inner surface of the eye may become dry, gritty, and sensitive to light and wind.
Irritation and infection. The eye may become red, inflamed, and prone to bacterial or viral infections, such as conjunctivitis or keratitis.
Corneal damage. The cornea, which is the clear outer layer of the eye, may develop ulcers or abrasions due to dryness or irritation, which can impair vision and cause pain.
Ectropion can usually be diagnosed by a physical examination of the eye and eyelid. The doctor may also perform some tests, such as:
Pulling or tugging on the eyelid to assess its muscle tone and elasticity.
Asking the patient to blink or close the eyes forcefully to see how well the eyelid covers the eye.
Examining the surrounding skin and tissue for signs of scarring, injury, or growths.
Measuring the tear production and drainage of the eye using special strips or drops.
The treatment of ectropion depends on the severity and cause of the condition. Some possible treatments are:
In addition to preventing further irritation and damage, artificial tears and ointments can provide temporary relief from the symptoms of ectropion. However, they cannot correct the underlying problem.
The most effective and permanent treatment for ectropion is surgery. A small portion of the eyelid is removed or skin is grafted from another part of the body to tighten and reposition the eyelid.
Medications such as Botox can temporarily paralyze the muscles that pull the upper eyelid outward, allowing it to rest on the eye. However, it is not a long-term solution and can cause drooping or difficulty blinking.
Ectropion cannot always be prevented, especially if it is due to aging or genetic factors. However, some steps that may help reduce the risk or delay the onset of ectropion are:
Protecting the eyes and eyelids from sun damage, injury, or infection by wearing sunglasses, hats, and sunscreen, and practicing good hygiene.
Managing chronic conditions that affect the facial nerves and muscles, such as diabetes, hypertension, or thyroid disorders, by following the doctor’s advice and taking the prescribed medications.
Avoiding smoking, excessive alcohol consumption, and other factors that may accelerate the aging process and weaken the eyelid muscles and tendons.
Seeking medical attention promptly if the eyelid becomes swollen, red, painful, or changes its shape or position.
