Ectropion is the turning out of the eyelid (usually the lower eyelid) so that the inner surface is exposed.

Ectropion is usually caused by the aging process and the weakening of the connective tissue of the eyelid, which causes the lid to turn out. It can also be caused by:

• A defect that occurs before birth (for example, in children with Down syndrome)
• Facial palsy
• Scar tissue from burns

• Dry, painful eyes
• Excess tearing of the eye (epiphora)
• Eyelid turns outward
• Long-term (chronic) conjunctivitis
• Keratitis
• Redness of the lid and white part of the eye

A physical examination of the eyes and eyelids confirms the diagnosis. Special tests are usually not necessary.

Artificial tears (a lubricant) may relieve dryness and keep the cornea lubricated. Surgery to tighten the muscles that hold the eyelids in place is usually effective. It may be performed as outpatient surgery with local anesthesia.

The outcome is expected to be good with treatment.

Corneal dryness and irritation may lead to:

• Corneal abrasions
• Corneal ulcers
• Eye infections

Corneal ulcers can threaten vision.

Call for an appointment with your health care provider if you develop symptoms of ectropion.

If you have ectropion, get medical attention if you experience the following emergency symptoms:

• Decreasing vision
• Pain
• Light sensitivity
• Rapidly increasing redness

Most cases are not preventable. Using artificial tears or lubricating ointments may prevent corneal complications.

Robinson FO, Collin JRO. Ectropion. In: Yanoff M, Duker JS, Augsburger JJ, et al, eds. Opthalmology. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2004:chap 88.

Wirbelauer C. Management of the red eye for the primary care physician. Am J Med. 2006;119:302-306.