Ectropion is the medical term used to describe an abnormal lower eyelid that turns outward and no longer touches the eye. As a result, the conjunctiva (the mucous membrane that lines the eyelid) may become red and exposed. This condition usually involves one or both lower eyelids but, rarely, may affect the upper eyelid(s).


Ectropion is usually due to relaxing of the tissues of the eyelid as a result of aging changes. Thus, it is most often seen in elderly people who develop stretching of the structures supporting the lower eyelid. It can also arise as a result of undetected skin cancers pulling down the eyelid, trauma, contraction of scar tissue( (from wounds, burns, or surgery) involving the skin surrounding the lower eyelid, and following eyelid or facial surgery.

Ectropion may develop following facial nerve palsy (Bells Palsy), in which the muscles surrounding the eye (and other facial muscles on the side of the face) are paralyzed. Finally, ectropion may be further aggravated due to constant wiping of excessive tearing, which tends to pull the eyelid further from the eye.


Ectropion can cause chronic irritation to the eyelid and the eye. This can result in excessive tearing, crusting of the eyelid and mucus discharge, infection, irritation of the cornea (the front part of the eye), and impaired vision. When the lower eyelid is turned outward and no longer touches the eye, it cannot properly spread the tear film across the eye which leads to poor drainage of tears through the nasolacrimal (tear drainage) system. The exposed inner lining of the eyelid becomes dry and inflamed. As a result the eye may become damaged.


To prevent dryness of the cornea because the tear film does not properly lubricate the eye, artificial tears and lubricating ointments may be used to keep the cornea moistened. A protective shield may be worn at night to keep the moisture in the eye. If the ectropion is due to laxity of the eyelids supporting structures, it is best treated surgically. Depending on the cause, surgery can reposition the eyelid back to its normal position against the eye. This can be accomplished by tightening the eyelid and its attachments to restore some of its elasticity and to reposition the eyelid. The surgical procedures are usually performed on an out patient basis using a local anesthetic. If the ectropion is a result of scaring, skin cancer, trauma, facial nerve palsy, or some other factor, treatment of the underlying condition may be done before or at the same time the ectropion is repaired.