Ectropion is a medical condition in which the lower eyelid turns outwards. It is one of the notable aspects of newborns exhibiting Harlequin type ichthyosis. The condition can be repaired surgically. Ectropion is also found in dogs as a genetic disorder in certain breeds.

Alternative Names of Ectropion are: Eversion of the Eyelid, Outward Turning of the Eyelid.

Complications of Ectropion

The main complications of ectropion are related to your cornea being exposed and your eye being open to infection.

Keratitis

This is when your cornea becomes inflamed, usually due to an infection. If the normally covered part of your cornea is left uncovered, it will be at risk of infection.

Corneal ulceration

Corneal ulceration is when ulcers (sores) develop on your cornea. It's a serious condition that can cause loss of sight. It's important to seek treatment from your GP immediately if you develop a red eye, a painful eye or it feels like something is in your eye.

Conjunctivitis

Conjunctivitis is an inflammation of your conjunctiva, the transparent layer that covers the white of your eye and lines your eyelids. If your conjunctiva becomes exposed and dried out or your cornea becomes inflamed or infected, the part of your conjunctiva that lines the inside of your eyelid may appear reddened and the white of your eye may become bloodshot.

Causes of Ectropion

• Congenital
• Aging
• Scarring
• Mechanical
• Allergic
• Facial nerve palsy
• Anti-cancer treatments such as erlotinib, cetuximab, and panitumumab, which block the function of EGFR (the epidermal growth factor receptor).

Signs & Symptoms of Ectropion

Often you will be able to see changes to your eyelid when you look at your eye in a mirror.

Symptoms of ectropion include:

• irritated, red eyes
• watering eyes - you may need to keep wiping your eyes
• you may be unable to close your eye fully
• difficulty blinking
• loss of vision (in severe cases)

Diagnosis of Ectropion

Your GP or optometrist (a health professional who examines eyes, tests sight and dispenses glasses and contact lenses) can diagnose your ectropion. He or she will ask about your symptoms and examine you, and may also ask you about your medical history. You may be referred to an ophthalmologist, a specialist who identifies and treats eye conditions (including surgical treatments).

Treatments of Ectropion

Your treatment will depend on the cause of your ectropion and how severe it is. If you only have mild symptoms or a facial palsy such as Bell's palsy which is expected to fix itself, there may be no need for treatment. There are simple self-help measures that you can use to reduce your symptoms.

Self-help

It's important to keep any exposed areas of your cornea moist and lubricated. You can do this using eye drops called preservative-free artificial tears, such as Celluvisc or Gel Tears. You can buy these from your pharmacist.

Taping your eyelid upwards with surgical tape can help stop your cornea being exposed if your lower eyelid is drooping. Taping will also help if you are unable to close your eye fully to sleep.

If your eyes keep watering, you should try to wipe your eye upward towards your nose rather than downwards, otherwise you may drag on your eyelid and make your symptoms worse.

Surgery
Surgery can be used to return your drooping eyelid to its normal position. This is done by tightening the skin, cartilage and muscles around your eyelid preventing it from sagging. It's usually done under local anaesthetic as an out-patient.

Occasionally a skin graft may be needed, especially if your ectropion is caused by damage or injury to the skin around your eyelid - a graft is usually taken from behind your ear. A skin graft is a cosmetic surgery technique that uses skin from another part of your body to repair a damaged area of skin that isn't going to be able to heal itself.

Before your surgery, it's very important to keep any exposed areas of your cornea moist and lubricated to prevent any infections or ulcers. You can do this by using preservative-free artificial tear drops in your eye which you should initially apply hourly. Alternatively, your GP may prescribe a lubricating eye ointment (e.g. LacriLube). However, you may only be able to use these drops at night as they can blur vision.

Prevention of Ectropion

Most cases are not preventable. Using artificial tears or lubricating ointments may prevent corneal complications.

When to seek Medical Advice

Although dry eyes don't usually cause permanent damage, diminished vision may prompt you to seek medical treatment. See your doctor if you've had prolonged signs and symptoms of dry eyes, including red, irritated, tired or painful eyes. Your doctor can take steps to determine what's bothering your eyes or refer you to a specialist.