Overview
Ectropion is a condition in which the lower eyelid turns outward, away from the surface of the eye. When the eyelid no longer rests against the eye, tears cannot drain normally and the eye surface is left exposed.
It is most often related to aging changes that loosen the eyelid tissues, but it can also follow facial nerve weakness, scarring from injury or surgery, sun damage, or prior eyelid procedures. Common symptoms include watery eyes, irritation, redness, and a gritty or dry sensation.
Because an exposed eye surface can become irritated or damaged over time, evaluation focuses on the cause and severity of the eyelid malposition and on protecting the eye, with treatment ranging from lubrication to eyelid surgery.
Symptoms
People with ectropion often have watery eyes, redness, irritation, and a dry or gritty feeling. The lower lid may look loose or rolled outward, and crusting or discharge can develop.
Because the eye surface is exposed, symptoms may worsen in wind or dry environments and can lead to repeated irritation or infection.
Causes and risk factors
The most common cause is age-related loosening of the eyelid tissues. Other causes include facial nerve weakness that reduces eyelid tone, scarring of the eyelid skin from injury, sun damage, or surgery, and the effects of prior eyelid procedures.
Identifying which of these is responsible matters because the surgical approach differs for loose-tissue, paralytic, and scar-related ectropion.
Living with ectropion? The next step is a quiet, unhurried conversation.
How it is diagnosed
Diagnosis is based on an eyelid and eye examination that assesses lid position, tone, and tear drainage, and looks for skin scarring or facial nerve weakness.
Care is often coordinated with ophthalmology, particularly when the surface of the eye is affected, to protect vision and eye health.
Treatment options
Treatment depends on the cause and severity:
- Lubricating drops and ointment to protect the eye surface
- Taping or moisture measures for temporary support
- Treating underlying skin or scar conditions
- Eyelid-tightening surgery to reposition the lid
- Skin grafting or flap procedures for scar-related ectropion
- Addressing facial nerve weakness when it is the underlying cause
Mild cases may be managed with lubrication, while persistent or symptomatic ectropion often improves with surgical repair.
When to seek care
Seek evaluation for a lower eyelid that turns outward with ongoing tearing, irritation, or redness, since the exposed eye surface can be injured over time.
Seek prompt care for significant eye pain, sudden vision changes, or signs of infection, which need attention beyond eyelid repositioning.
Living with ectropion? The next step is a quiet, unhurried conversation.
Clinical references
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Common Symptoms
Living with ectropion? The next step is a quiet, unhurried conversation.
Treatment Approach
Treatment for ectropion is individualized based on the severity of symptoms, anatomical considerations, and patient goals. Our specialists may consider:
- 01Lubricating eye drops and ointment to protect the surface
- 02Taping or moisture measures for temporary support
- 03Treating underlying skin or scar conditions
- 04Eyelid-tightening surgery to reposition the lid
- 05Skin grafting or flap procedures for scar-related ectropion
- 06Addressing facial nerve weakness when it is the cause
Specialists who treat ectropion
Dr. Moustafa Mourad
MD, FACS
Double Board-Certified Head & Neck and Facial Plastic & Reconstructive Surgeon
Dr. Moustafa Mourad is a double board-certified head and neck and facial plastic and reconstructive surgeon who cares for the full range of cosmetic and complex conditions affecting the face, head, and neck.
- Facial plastic and reconstructive surgery
- Head and neck cancer surgery
- Microvascular free-flap reconstruction
- Facial trauma and reconstruction
Also caring for this area
Not sure who to see? Our patient coordination team can help match you with the right specialist.
(212) 444-8006Frequently Asked Questions
Ectropion is an outward turning of the lower eyelid so that it pulls away from the eye. This allows tears to spill over and leaves the eye surface exposed, leading to tearing, irritation, and dryness.
The most common cause is age-related loosening of the eyelid tissues. It can also result from facial nerve weakness, scarring of the eyelid skin, sun damage, or prior eyelid surgery.
When the eyelid does not rest against the eye, tears cannot reach their drainage opening and instead spill over. The exposed surface can also become irritated, which increases tearing.
Lubricating drops and ointment, along with measures to protect the eye, can ease symptoms in mild cases. Persistent or symptomatic ectropion is often improved with surgical repair.
Repair depends on the cause and may involve tightening the eyelid, releasing or grafting scarred tissue, or addressing facial nerve weakness. The goal is to restore the lid to its normal position and protect the eye.
In ectropion the eyelid turns outward, away from the eye, while in entropion it turns inward so the lashes rub against the eye. Both can cause irritation but are repaired differently.
It can be. When the facial nerve is weak, the lower eyelid can lose tone and turn outward. In these cases, treatment also considers eye protection and the underlying facial weakness.
A chronically exposed eye surface can become dry, irritated, and prone to infection, and in some cases this can affect the cornea. Evaluation helps protect eye health while addressing the eyelid.
Related Procedures
1 of 3 · Ectropion Surgery
Related Conditions
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