Ectropion is defined as an outward rotation of the anatomical eyelid margin away from the globe. It is commonly seen with the aging population as the main etiology is horizontal laxity of the eyelid tissues. Other risk factors include previous trauma, glaucoma drops, facial palsy and chronic sun exposure. Patients may complain of chronic ocular redness, irritation, and foreign body sensation.
Since the tear-duct opening is on the eyelid itself, ectropion causes an inability to drain the normal tears, so patients may also complain of tearing.
Patients need to be reminded to avoid wiping their eyelids in a horizontal or downwards fashion. Reducing sun and UV exposure may also help to prevent some cases of ectropion.
Early in the disease, relief may be obtained by wiping the eyes in a vertical manner and avoiding any horizontal traction on the eyelids. Severe ectropion secondary to topical drops may necessitate changing the topical agents or even discontinuation of the drops.
Most patients with lid retraction can be initially managed with topical lubricating drops during the day and lubricating gels at night. Most patients with ectropion will eventually need surgery to reposition their eyelids. If the ectropion has been longstanding and severe, skin-grafting procedures may also be required.