Ectropion is the turning out of the eyelid (usually the lower eyelid) so that the inner surface is exposed.

Causes, incidence, and risk factors

Ectropion is usually caused by the aging process and the weakening of the connective tissue of the eyelid, which causes the lid to turn out. It can also be caused by contraction of scar tissue from burns or from facial palsy and may occur as a congenital defect (for example, in children with Down syndrome).

Ectropion interferes with normal distribution of tears on the surface of the eye and may result in dry painful eyes, chronic conjunctivitis, and keratitis.


  • Excess tearing of the eye, also called epiphora  
  • Visible outward turning of the eyelid  
  • Redness of the lid and conjunctiva

Signs and tests

A physical examination of the eyes and eyelids confirms the diagnosis. Special tests are usually not necessary.


Artificial tears (a lubricant) may provide relief from dryness and keep the cornea lubricated. Surgery to tighten the muscles that hold the eyelids in place is usually effective and may be performed as outpatient surgery with local anesthetic.

Expectations (prognosis)

The outcome is expected to be good with treatment.


Corneal dryness and irritation may predispose the patient to eye infections, corneal abrasions, or corneal ulcers.

Calling your health care provider

Call for an appointment with your health care provider if symptoms develop (to check for corneal abrasions or corneal ulcers). Corneal ulcer is a vision-threatening condition.

Rapidly increasing redness, pain, light sensitivity, or decreasing vision should be considered an emergency in a person with ectropion.


Most cases are not preventable. Use of artificial tears or lubricating ointments may prevent corneal complications.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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