Eyelid Turns Out (Ectropion)

What is ectropion?

Normally the upper and lower eyelids rest comfortably against the surface of the eye. They help to protect the surface of the eye and keep it moist and lubricated with your tears. Ectropion happens when the eyelid (usually the lower eyelid) turns out away from the eye. This can lead to drying of the front of the eye, which can cause irritation, redness, and a watery eye, and may increase your risk for an infection.

What is the cause?

Different types of ectropion happen from different causes:

• The eyelid tissues become too loose, and cause the eyelid to turn out. Eyelid tissues usually get looser as you get older.
• The skin of the eyelid becomes scarred and pulls the eyelid out away from the eye. Scarring can happen from many causes including injury, surgery, sun damage, and skin cancer.
• The nerve controlling the muscles in the face and eyelid becomes paralyzed. The loss of muscle tone results in sagging and turning out of the lower eyelid.

What are the symptoms?

Symptoms of ectropion include:

• gritty feeling
• watery eyes
• decreased or cloudy vision
• discharge
• redness of the eye
• sharp pain in the eyes

How is it diagnosed?

Your child’s eye care provider will ask about symptoms, examine your child’s eyes, and do tests such as:

• an exam using a special microscope (a slit lamp) to look closely at the eye
• photographs to document the appearance of the eyelids and to help in your child’s follow up care

How is it treated?

For mild ectropion, artificial tear drops and ointment may keep your child’s eye comfortable. More severe ectropion will require surgery. Your child’s healthcare provider may recommend surgery to tighten the eyelid. This may be done with or without a skin graft, often using a small piece of the extra skin of the upper eyelid.

How long will the effects last?

Ectropion, if not corrected by surgery, gradually gets worse over time. Your child’s eyelid and eye may get more irritated over time. The opening of the tear drainage system in the inner corner of the lower eyelid may become scarred and shut, causing your child’s eye to water all the time.

How can I prevent ectropion?

Ectropion cannot be prevented. However, regular eye exams will allow your child’s eye care provider to start treatment earlier.