Eyelids That Turn Out | Eyelids Turning Outwards


This patient actually has an ectropion of both lower eyelids. His left one is worse than his right.

What is an Ectropion?

Ectropion refers to when the eyelid no longer lies snugly against the eyeball and turns outwards and most commonly affects the lower eyelid.


How is an Eyelid Ectropion treated?

  • default_titleThe best option for treating ectropion is by surgery. The type of surgery performed is varies from patient to patient depending on the reasons why that patient has an ectropion in the first place.
  • default_titleFor most patients, surgery tightens up the lower eyelid horizontally and reduces any downward pull on the eyelid. This will result in restoring the lower eyelid to its normal position, so that it fits snugly against the eyeball.
  • default_title If the ectropion is caused by scarring then the operation may involve more extensive surgery- sometimes involving the use of skin grafts or skin flaps to relieve the tension caused by the scar tissue. Most operations can be done quite comfortably and quickly using a local anaesthetic injection as a day case procedure.
  • default_titleUncommonly where surgery is not a desired option, some oculoplastic surgeons may consider injecting some hyalauronic acid filler in front of an turned out eyelid to prop it back into position. This is a temporary option but can be useful for patients unsuitable for surgery
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Do all Ectropions need treatment?

No. Not all ectropions need treatment. Indeed many patients opt to leave their ectropions alone and decline the option of surgery.
However common reasons for ectropion treatment include:
  • default_titleCosmetic: the patient simply does not like the look of their out turning eyelid.
  • default_titleFunctional: the patient is bothered by symptoms of irritation or watering of the eye. The position of the lower eyelid is important to keep the ocular surface comfortable. In some patients with an ectropion, if the lower eyelid is too low down, the surface of the eye can dry out causing discomfort and irritation.
  • default_titlePreventative safety: the patient needs to undergo intraocular surgery in the future such as a cataract surgery. As an ectropion prevents normal drainage of one's tears away into the tear duct, theoretically the tears contain more bacterial organisms. The presence of an ectropion thus results in a theoretically higher risk of post cataract surgery vision threatening bacterial eye infection (endophthalmitis). Thus treatment of the ectropion first prior to the intraocular surgery would be recomended.
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... I was referred to Mr Cheung by my doctor. He told me what I needed doing, which was that my top and bottom eye lids need to be tightened up and tear ducts washed out (nip and tuck). It involved injections around the eyes. I was rather nervous but need not have worried. He has done a lovely job. I have not had any problems since. I wish to thank Mr Cheung for the excellent job he and his team did.
Mrs CD (Birmingham). Surgery performed: bilateral upper lid blepharoplasty, bilateral lower lid tightening and ectropion correction.