Ectropion and entropion Dr Rob Hicks As we age, our skin and the tissue beneath it becomes more lax. If this occurs to the muscles around the eyes, the eyelids may rotate inwards or outwards.

In this article

What is ectropion?

What is entropian?

What's the treatment?

If the lower eyelid turns outwards, it starts to hang away from the eyeball and forms a small bucket or pocket.

This may not cause any problems. But as tears collect, the bucket overflows and the lower eyes may water constantly.

In contrast, the middle part of the eyeball becomes exposed, dry and irritated, which may allow recurrent infections to occur.

When ectropion is due to ageing, usually both eyes are affected. If only one is affected, this may be the result of scarring on the eyelid or upper cheek. As this scar heals and tightens it tugs at the lower eyelid, pulling it down.

Ectropion can also occur when the nerve supplying the lower eyelid muscle has been damaged, causing the muscle to be paralysed.

When the upper, lower or both eyelids turn inwards, the eyelashes can rub against the eyeball. This irritates the eye, which can feel painful and watery. Damage to the cornea, the clear front part of the eye, may cause an ulcer to develop that can lead to loss of vision if not treated.

Entropion usually occurs as a consequence of the ageing process. In developing countries, however, infection affecting the inner surface of the eyelid is a relatively common cause. When this heals, it can leave scar tissue that pulls the outer border of the eyelid inwards.

In a condition called trichiasis, the eyelashes grow inwards, causing identical problems to entropion.

Daily eye cleansing with boiled water that's been allowed to cool, or with an eye wash solution from the pharmacist, can help to keep the eye clean and soothe any symptoms of irritation and soreness. Any infection can be easily treated with antibiotic drops or ointment.

It's possible to have a minor operation on the eyelid to tighten the skin and muscles. The sooner this is done the better, to avoid further damage to the eye. You may be advised to tape the eye closed to protect it until surgery is performed.

The operation is usually done as a day case under local anaesthetic.

This article was last medically reviewed by Dr Rob Hicks in February 2008