Ectropion is defined as the eversion of the eyelid from its normal position adjacent to the globe. While it can affect either the upper or lower eyelid, it more commonly involves the lower eyelid. The sagging lower lid leaves the eye exposed and dry.
The most common form of ectropion, involutional ectropion is usually seen with advancing age. However, many other conditions can lead to ectropion. Mechanical causes, such as eyelid tumors, cicatricial causes such as chemical burns or overly aggressive blepharoplasty surgery, and allergic dermatitis call all lead to ectropion. It is also seen in association with Bell's palsy, secondary to the loss of muscle tone.
In milder cases of ectropion, patients may be may be asymptomatic. As the condition progresses, symptoms include excess tearing, foreign body sensation, red eyes, irritation, and blurred vision. Continued blotting of the excess tears only serves to exacerbate the condition. The everted eyelid also prevents the normal tear film from lubricating the lower part of the cornea, which can lead to ulceration and infection.
Initial treatment of ectropion consists topical lubrication. The eyelid can be temporarily taped into proper position. There are a number of surgical options for the treatment of ectropion, each of which must be directed at the underlying etiology. The goal of the surgery is to restore the eyelid and lid margin to its normal anatomic position in direct contact with the globe. The surgery is performed on an outpatient basis, and under local anesthesia.