Your eyelids serve an important purpose to protect the surface of the eye. Normally, the upper and lower lids close over the eye, each time bathing the delicate ocular tissues in moisture. This helps to prevent eye dryness, irritation and potential injury and infection. When your eyelid is not in its proper anatomical position, it cannot serve its protective and lubricating functions. Fortunately, there is treatment available for eyelid malposition such as ectropion. 

• What is Ectropion?
• What are Symptoms of Ectropion?
• How is Ectropion Diagnosed?
• What Causes Ectropion?
• How is Ectropion Treated?
• Is Ectropion Repair Surgery Covered by Insurance?

Ectropion is a condition where your eyelid turns away from the eyeball, exposing the pink lining of the inner eyelid. Typically, this occurs on the lower eyelid, and it can affect just one or both eyes. If the condition is severe, the entire lower lid can turn outward. Less severe cases only affect a portion of the length of the lower lid. In any case, ectropion can cause tearing, dryness and exposure of the eye which can affect your vision and cause discomfort. Ectropion should be corrected as soon as possible to avoid injury and potential infection of the eye.

If mild, ectropion can be painless and only mildly irritating. In more severe cases where the eyeball is exposed and dry, you may experience significant discomfort or pain. 

When the eyelid is rolled away from the eye, your tears are unable to drain properly into the small ducts in the corners of your eyelid. This may cause excessive watering of the eyes with tears spilling onto your face.

Ectropion can present with several symptoms, including: 

• Excessive tearing and watery eyes
• Dryness, grittiness, burning sensation
• Foreign body sensation, feeling like something is in your eye
• Redness 
• Blurry vision 
• Light sensitivity
• Mucus discharge

Ectropion can easily be diagnosed at your regular routine eye exam. Specialized tests are not needed.

Knowing the cause of the ectropion is the first step toward determining a personalized treatment plan to correct the condition. A thorough history will be helpful, including reporting your symptoms, when they started and if the problem occurs intermittently or constantly. Make sure to provide your doctor with any history of prior head and facial trauma or surgeries. Your doctor will examine the outward appearance of your eyes and eyelids during this exam and may gently pull on your eyelid or ask you to blink to assess muscle tone. Your doctor will review the severity of the exam findings with you.

Ectropion is usually caused when the muscles and tendons around the eye become loose and stretched or pulled in a certain direction. The most common reasons are age-related changes, but other possible causes include:

• Laxity of the muscles and tendons that hold the eyelid taught 
• Chronic rubbing of the eye 
• Chronic friction from long-term use of contact lenses
• Benign or cancerous growths that distort the normal shape of the eyelid
• Facial paralysis caused by stroke, tumors, or Bell’s palsy
• Scars from burns or previous facial or eyelid surgeries
• Prior eyelid surgeries, such as lower eyelid blepharoplasty
• Direct trauma such as a car accident could cause damage to the eyelid
• Genetic disorders, although this is fairly rare.

No matter the cause, ectropion should be treated quickly to avoid exposure and injury to the ocular surface. If left untreated, infection, scarring and loss of vision are possible consequences.

Ectropion is very treatable, and there is no reason for you to continue suffering from its uncomfortable effects. 

Topical lubricating drops and ointments are typically the first line of treatment to help relieve the discomfort ectropion can cause. In some cases, topical antibiotic prescriptions may be sent to your pharmacy.

In most cases, when ectropion is persistent and does not resolve, surgery can be performed to correct the malposition. The kind of surgery your doctor selects will depend on what is causing the ectropion to occur. Because most cases are due to age-related laxity of the eyelid tendons and muscles, horizontal tightening of the eyelid should correct the issue.

Ectropion repair surgery is performed on an outpatient basis, so you will return home once the procedure is completed. Anesthesia involves a local injection to numb the area, and possibly light sedation. Thus, you should arrange a driver for the day of surgery.

Surgery to correct ectropion is very successful in the vast majority of cases. Recovery from the procedure may require you to wear an eyepatch for a short time as well as continue using eye drops or antibiotic ointment. You may experience some bruising and swelling which will go away over time. Any sutures may be removed approximately one week later. As you heal, your eyelid will get back to its normal function and the tearing, discomfort, or other symptoms you experienced will go away. 

Surgical correction of eyelid malposition is generally performed as a functional (medically indicated) surgery. Therefore, most medical insurances should provide coverage for this procedure.

Ocala Eyes offers board-certified ophthalmologists who devote themselves to your comprehensive eye care.   

Our eyelid surgeries are performed by Dr. Sarah Kim. She is a board certified physician and surgeon who completed a residency in ophthalmology and fellowship in oculoplastics. This means the safety of your eyes and vision are a top priority during any medical or cosmetic eyelid procedure. Click here to meet your eyelid surgeon!