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What it is

Ectropion happens when the lower eyelid sags or turns outward, away from the eye. Tears do not drain the way they should, and the eye can become dry and irritated.

Symptoms

  • Watery eyes, with tears running down the cheek
  • Dryness, grittiness or burning
  • Redness of the eye and the inner eyelid
  • Crusting on the eyelid
  • A lower lid that looks loose or pulled down

Causes

  • Aging, as the eyelid tissues loosen (the most common cause)
  • Scarring or tight skin from sun damage, burns, skin conditions or past surgery
  • Weakness of the facial nerve, as in Bell’s palsy
  • Less often, a lump on the eyelid that pulls it down

Assessment

Dr. Conlon checks how loose the eyelid is, the skin and the facial muscles, and how your tears drain. The front surface of the eye is checked for dryness or damage.

Treatment options

  • Comfort measures: lubricating drops and ointment can protect the eye while you wait for surgery, or when surgery is not right for you.
  • Surgery: the eyelid is tightened, usually at the outer corner. If the skin is tight or scarred, a skin graft may be needed. A small procedure on the inner side of the lid can also help turn it back toward the eye.

The right choice depends on the cause.

Recovery overview

Bruising and swelling usually settle over about 1–2 weeks. You will use ointment on the incision and cold compresses for the first day or two. Avoid heavy lifting for about a week, or as Dr. Conlon advises.

Risks

Risks include bleeding, infection, scarring, the eyelid feeling tight or looking uneven, and the problem returning over time.

When to seek urgent care

See an eye doctor promptly if your eye becomes painful, very red or light-sensitive, or if your vision gets worse.

Frequently asked questions

Why does my eye water if it feels dry?

When the lid turns out, tears do not spread across the eye or drain properly. The eye can feel dry and water at the same time.

Will ectropion go away by itself?

Age-related ectropion usually does not. Ectropion from facial nerve weakness can sometimes improve as the nerve recovers.

Is surgery covered?

Saskatchewan Health generally covers ectropion repair when it is medically necessary.

Conlon Eye Institute, Medical Arts Building, 341-750 Spadina Crescent East, Saskatoon SK S7K 3H3. Fax 306-244-9904.

You can book without a referral. Referrals from your optometrist or family doctor are also welcome.