Summary
In ectropion, the lower eyelid turns outwards so its inner surface is exposed to the elements. The eye runs constantly, the eyelid skin becomes red and rough, and over time the surface of the eye can be damaged.
Who is this for?
Common causes are:
- Age-related laxity - by far the most common.
- Cicatricial ectropion - scarring of the lower-lid skin pulling the lid downwards (sun damage, previous skin cancer surgery, chronic dermatitis).
- Paralytic ectropion - facial nerve weakness, e.g. after Bell’s palsy.
- Mechanical ectropion - heavy tumours of the lower lid weighing it down.
Common symptoms include constant watering, a sore red eye, exposure of the inner pink lining (the conjunctiva), and recurrent infections.
What the procedure involves
For most age-related cases I perform a procedure to tighten the lower eyelid. Often this is combined with a mini face lift for added support to the lower eyelid. For cicatricial cases, additional skin grafting may be needed to release the scar tension.
Typical operating time is 45 minutes per eyelid under local anaesthetic, as a day case.
Recovery and what to expect
- Bruising and swelling for 1–2 weeks.
- Lubricants and antibiotic ointment for a week.
- Sutures absorb or are removed at 7–10 days.
- Watering improves rapidly once the lid sits against the eye again.
Risks and alternatives
As with any eyelid surgery, risks include asymmetry, under- or over-correction, infection, scarring and recurrence. Long-term success rates are above 90% for age-related ectropion.
Non-surgical management with intensive lubrication and taping can provide temporary relief but is not a long-term solution.