An ectropion happens when the lower eyelid sags away from your eye, leaving the inner surface of the eyelid exposed. It can happen in one eye or both eyes. When the lower eyelid droops away from the eye, it can affect the ability of teardrops to drain properly. This can cause the eye to water excessively, as well as feel dry and gritty. The eyes can also become red, sore, and inflamed and this makes the eye more vulnerable to infections such as conjunctivitis. In severe untreated cases, it's possible to develop a corneal ulcer (a sore on the eye's surface) that could affect your vision. But this is rare. An ectropion is different from an entropion, which is where the eyelid turns inwards, towards the eye.
The risk of an ectropion increases with age. It is thought that this occurs because the tissues and muscles of the eyelid become weaker and more likely to droop the older you become. Other things that can cause the eyelid to droop include damage to the nerves that control the eye, structural problems occurring around the eye that can cause pressure on the eyelid like a lump or cyst, or as a result of injury or trauma to the skin.
Ectropions are usually not something to worry about, although they can be uncomfortable. Minor problems can be managed at home with some simple techniques. It is best to avoid constantly touching or wiping your eyelid, as this can introduce infection and worsen the issue. Gentle wiping can be done from the outside of the eye inwards (towards the nose). Eye drops and ointments can also be used each day to keep the eye lubricated and prevent any complications linked to dryness. In more severe cases, an eye specialist may recommend that you have an operation to reduce the droop of the eye. This normally happens as a day case (meaning you won’t need to stay overnight) without needing to be put to sleep.
If you think you have an ectropion, and if it is causing you bothersome symptoms then you should book a routine appointment with your doctor. Your doctor will be able to diagnose an ectropion by looking at your eye. If your doctor has any concerns, they may refer you to a specialist eye doctor for further assessment and treatment. More concerning symptoms that may require immediate assessment at your nearest emergency department include symptoms of a very red and painful eye or any reduced or loss of vision.
It's not possible to prevent an ectropion from happening, but the sooner you get it reviewed and assessed the better.