An ectropion is an outward-facing (everted) lower eyelid: the insides of the lower eyelids are constantly exposed to the air and dry out.
Most commonly, ectropion appears as a symptom of aging, whereby eyelid tissue relaxes horizontally. In rare cases it can also be caused by skin diseases, infections or scarring of the skin of the lower eyelid. Irrespective of the cause, the outcome is the same: the eye becomes permanently irritated because the eyelids no longer close properly and dry out the surface of the eye. Often there is a compensatory excess production of tears, resulting in a watery eye – but the tears can not flow properly because of the malpositioning of the lower eyelid.
Long-term ectropion predisposes patients to developing corneal infections, which can lead to serious changes, in extreme cases to a corneal ulcer.
Ectropion surgery, much like entropion surgery, can be corrected by horizontally and vertically tightening the lower eyelid. The operation lasts about 45 minutes, is usually performed under local anaesthesia, and the success rate is 70–80%.
Under certain circumstances – if the ectropion is caused by a shortening of the lower lid, usually as a consequence of scar tissue production or skin disease – then skin transplantation may be necessary. For this, we can transplant skin from the upper lid of the same side or the opposite side, or even skin behind the ear.
Although infections of the wound area are possible, they are extremely rare after this type of eyelid surgery and are treated with antibiotics.
It’s important to realise that a 100% perfect result is not always possible after surgery (especially when the ectropion has been around for a long time), so despite achieving a big improvement, in around 1 in 10 cases, no normalisation of lid position can be achieved.