Ectropion
What is ectropion?
Ectropion is a sagging or outward
turning of an eyelid. It often affects a lower eyelid. Ectropion often affects both
lower eyelids. But in some cases it only affects one side.
Your eyelids help protect the outer
part of your eye. The cornea is the clear part of the eye. It covers your iris and your
pupil. The conjunctiva is a thin layer of tissue. It covers the inside of your eyelids
and the white part of your eye (the sclera). The eyelids help keep your cornea and your
conjunctiva moist with tears. This helps prevent eye irritation and infection.
When your eyelids turn outward, the
cornea and conjunctiva are exposed. They can get dry, irritated, and even infected. This
can lead to serious symptoms. In some cases, it can lead to vision loss.
What causes ectropion?
Ectropion is caused by many things.
There are different types that depend on the causes. Some types of ectropion are present
from birth (congenital). Other types happen later in life (acquired). These are the
types of acquired ectropion:
-
Involutional ectropion. This often
occurs as you get older. Over time, the collagen and elastic fibers in your eyelid
can get weak. This causes your eyelid tissue to become very loose. Gravity can then
cause your eyelid to fall open. This is the most common type of ectropion. It is most
common in older adults. The other types of ectropion are rare.
-
Cicatricial ectropion. This is caused
by an abnormal contraction of your lower lid, often from scarring. This makes your
lid open in an outward direction. It is possibly due to an eye infection, an eye
injury, or problems after eye surgery. A bacterial infection called trachoma is a
leading cause of this type of ectropion.
-
Paralytic ectropion. This is due to a
problem with the facial nerve. This nerve sends signals to the muscle right under
your eye. Problems with the nerve can cause other problems in facial movement.
Cranial nerve paralysis may happen as a result of a stroke.
-
Mechanical ectropion. This happens
when a tumor or other mass in your eyelid pulls the eyelid down.
Who is at risk for ectropion?
Being older raises your risk for
ectropion. Your child may be more likely to have ectropion if he or she has a health
condition from birth that can cause it. This includes Down syndrome.
What are the symptoms of ectropion?
Symptoms are caused by the cornea
and conjunctiva being exposed. Symptoms can include:
-
Excess tearing
-
Dry eyes
-
Inability to close the eyelids
completely (especially with paralytic ectropion)
-
Eye and eyelid itching, burning, or
crusting (from chronic conjunctivitis)
-
Blurry vision, sensitivity to light,
and eye pain (from infection or ulceration of the cornea)
Sometimes ectropion is part of
something called floppy eyelid syndrome. With this syndrome, your upper eyelids may
easily turn inside out. You may often wake up with an eyelid that has turned inside out.
Floppy eyelid syndrome can lead to symptoms like those of ectropion.
How is ectropion diagnosed?
Your eye care provider will ask
about your health history and give you a physical exam. This will include an eye exam.
Other tests are not needed to diagnose ectropion.
How is ectropion treated?
You may first use treatments such
as:
Over time, many people with ectropion will need some type of surgery.
The type of surgery will depend on the cause of the ectropion. For example, your surgeon
may need to remove excess skin. Your surgeon might need a donor skin graft to lengthen
the skin under your eye. You may need a tumor removed from your eyelid. In most cases,
surgery eases symptoms completely.
What are possible complications of ectropion?
Corneal infection leading to
corneal ulcer is the most serious possible complication of ectropion. It can sometimes
cause long-term damage. If your cornea gets scarred, light can't pass through it
normally to reach the rest of your eye. Corneal infection and corneal ulcer can severely
damage vision. This requires emergency evaluation and treatment.
It's important to follow your
provider’s instructions after treatment. This may help reduce your risk for corneal
infection and corneal ulcer. Seek medical care right away if you have any symptoms.
Symptoms of corneal infection and corneal ulcer include:
-
Blurry vision
-
More sensitivity to light
-
Severe eye pain and soreness
-
Increased eye redness
-
Eye discharge
-
Swollen eyelids
-
White spot on your cornea that you may not be able to see
When should I call my healthcare provider?
Call 911 if you have rapidly increasing pain,
redness, light sensitivity, or decreasing vision. These might be signs of a corneal
infection. You will need treatment right away to prevent permanent vision damage or even
blindness.
Key points about ectropion
-
Ectropion is a sagging or outward turning of an eyelid. It often
affects a lower eyelid.
-
Various causes can lead to ectropion.
The most common cause is getting older. With age, the muscle and skin under your eye
become weak.
-
Sometimes it is present at birth
(congenital). It may be linked to another health problem, such as Down syndrome.
-
Over time, you will likely need
surgery. This often relieves symptoms completely.
-
Seek medical care right away if you
have any symptoms of corneal infection or corneal ulcer. This can prevent permanent
vision damage or loss.
Next steps
Tips to help you get the most from a visit to your healthcare
provider:
-
Know the reason for your visit and
what you want to happen.
-
Before your visit, write down
questions you want answered.
-
Bring someone with you to help you ask
questions and remember what your provider tells you.
-
At the visit, write down the name of a
new diagnosis, and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you.
-
Know why a new medicine or treatment
is prescribed, and how it will help you. Also know what the side effects are.
-
Ask if your condition can be treated
in other ways.
-
Know why a test or procedure is
recommended and what the results could mean.
-
Know what to expect if you do not take
the medicine or have the test or procedure.
-
If you have a follow-up appointment,
write down the date, time, and purpose for that visit.
-
Know how you can contact your provider
if you have questions.
Online Medical Reviewer:
Chris Haupert MD
Online Medical Reviewer:
Daphne Pierce-Smith RN MSN CCRC
Online Medical Reviewer:
Rita Sather RN
Date Last Reviewed:
2/1/2019
© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.