Ectropion, or out-turning, of the eyelid usually involves the lower eyelid. The lower eyelid pulls away from the eye and visibly appears to sag down. Symptoms include irritation, swelling, and redness of the eyelid, tearing, and irritation and redness of the eye. The lower eyelid is usually pressed flush against the eye and keeps the eye bathed in lubricating tears. When the eyelid sags away, so do the tears, and the eye can become severely dry. Tearing occurs if the opening in the eyelid which drains tears away becomes separated from the eye. Thus, tears have no way to drain away except onto the face. Dryness of the cornea can lead to a scratchy sensation, redness of the eye, pain, and blurred vision. Sometimes the cornea can become infected.
Most of the time, ectropion occurs along with the general aging changes in the skin. The lower eyelid can become looser, and eventually pull away from the eye by gravity. Bell's Palsy, or a temporary paralysis of the side of the face, can suddenly make these normal aging changes much worse, and the eye can become severely dry due to ectropion. Other conditions lead to scarring of the skin under the eyelid, which pulls the eyelid away from the eye.
Treatment of ectropion in some cases is merely to lubricate the eye as best as possible, with artificial tears during the day and ointment at night. In more severe cases, or if the cornea is at risk due to severe dryness, the eyelid out-turning can be corrected surgically under local anesthesia.
