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Ectropion (ek-TROH-pee-on) is a condition in which your eyelid — typically the lower lid — turns out. This leaves the inner eyelid surface exposed and prone to irritation. Ectropion is more common in older adults.
In severe ectropion, the entire length of the eyelid is turned out. When ectropion is less severe, only one segment of the eyelid sags away from the eye.
Artificial tears can help relieve the symptoms caused by ectropion until you can have surgery to correct the condition.
Normally when you blink, your eyelids distribute tears evenly across your eyes, keeping them lubricated. These tears drain into the little openings on the inner part of your eyelids (puncta). When you have ectropion, your lower lid pulls away from your eye and tears don't drain into the puncta properly, causing a number of signs and symptoms:
Irritation. Stagnant tears or dryness can irritate your eyes, causing a burning sensation and redness in your eyelids and the whites of your eyes. The stagnant tears and dryness can also irritate the surface of the cornea, making you sensitive to light.
Excessive tearing. Without proper drainage, your tears may pool and constantly flow over your eyelids. Many people with ectropion complain of watery or weepy eyes.
Excessive dryness. Ectropion can cause your eyes to feel dry, gritty and sandy.
There are several different surgical techniques for ectropion, depending on the cause and the condition of the tissue surrounding your eyelid. Before the surgery, you'll receive a local anesthetic to numb your eye and the area around it. You may be lightly sedated using oral or intravenous (IV) medication to make you more comfortable, depending on the type of procedure you're having and whether or not the surgery is performed in an outpatient surgical clinic.
If your ectropion is caused by muscle and ligament relaxation due to aging, your surgeon will likely remove a small part of your lower eyelid at the outer edge. When the lid is sutured back together, the tendons and muscles of the lid will be tightened, causing the lid to rest properly on the eye. You'll have a few stitches on the outside corner of your eye or just below your lower eyelid. In general, this procedure is relatively simple and will be the only surgery you need.
If you have scar tissue from an injury or previous surgery, the surgeon may need to use a skin graft, taken from your upper eyelid or behind your ear, to help support the lower lid. If you have facial paralysis or significant scarring, the outcome of surgery is less predictable, and more than one procedure may be necessary before your ectropion is completely resolved.