The eyelid drooped
The lower eyelid moves away from the eye, the edge turns out, the red inner membrane is visible.
CONDITION / FACE
Ectropion: eversion of the lower eyelid.
Ectropion is an inversion of the lower eyelid to the outside, due to which the eye becomes watery, dry and less protected. Most often, it appears with age, less often - due to scars or paralysis of the facial nerve; if it interferes, it is corrected by surgery.
CONCEPTUAL VISUALIZATION- What it is
- The lower eyelid moves away from the eye, and its edge turns outward.
- How common
- Most often, a violation of the position of the eyelids; in a survey of 24,565 elderly people, 2.9% had age-related ectropion.
- What bothers
- Tearing, dryness, redness; the eye is less protected.
- Who treats it
- A surgeon who operates on the eyelids; An ophthalmologist also assesses the condition of the eye.
01 / WHAT IS ITWhat is
What is
ectropion
Ectropion is a condition in which the edge of the eyelid, usually the lower, turns outward. The inner membrane of the eyelid and the surface of the eye remain open, so the eye becomes dry, red and watery. This is most often a violation of the position of the eyelids.
Ectropion can be acquired or congenital; acquired occurs much more often. According to the cause, it is divided into age-related (doctors say "involutional"), cicatricial, paralytic and mechanical. Most often, it occurs in the elderly, and due to the aging of the population, such patients are becoming more numerous.
Ectropion itself is usually not dangerous. But if it is not treated for a long time, repeated inflammations of the conjunctiva and cornea, erosion of the cornea, and in severe cases even loss of vision are possible.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow
How
ectropion presents.
Ectropion can be in one eye or both. The most noticeable thing is a drooping eyelid, but patients are usually more concerned about the eye itself.
Lacrimation
The eye constantly tears, tears run down the cheek - in particular, because the lacrimal point turned away from the eye.
Dryness and irritation
Feeling of sand in the eye, redness of the eye and eyelid; infections such as conjunctivitis are more common.
The eye does not close
The eyelids are difficult to close completely—especially when ectropion is associated with facial nerve palsy.
Lagophthalmus03 / REASONSWhy the eyelid?
Why the eyelid?
turns out
Which operation is chosen depends on the reason. Less often, ectropion causes prolonged instillation of drops into the eye. Congenital ectropion is rare, usually with other eyelid defects.
age
The most common reason: with age, the tissues around the eye weaken and the eyelid stretches. In a survey of 24,565 elderly people, 2.9% — 5.1% of men and 1.5% of women had age-related ectropion.
Scars
A scar after an injury, burn, skin disease, tumor removal, or eyelid surgery shortens the skin and pulls the eyelid down.
Scars after facial injuriesParalysis of the facial nerve
When the nerve does not work, the eyelid droops and the eye closes more poorly. Such ectropion increases the risk of corneal damage.
Paralysis of the facial nerveNeoplasms
A tumor, cyst, or inflammation on the eyelid pulls its edge outward — this is mechanical ectropion.
Neoplasms of the eyelids
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Ectropion is usually not dangerous and does not require emergency care. But the open eye is less protected, and after an injury or surgery on the eyelids, some signs require immediate help.
103 immediately if:
- suddenly stopped seeing in one or both eyes;
- sudden severe pain in or around the eye;
- after an injury or surgery on the eyelids, severe pain in or around the eye that grows;
- after an injury or surgery on the eyelids, the eye protrudes or became tense;
- after an injury or surgery on the eyelids, the eyelids do not open;
- after an injury or surgery on the eyelids, double vision appeared or vision worsened.
To the doctor on the same day, if:
The eye is very red or painful, vision changes, photophobia or headache with nausea or vomiting. If the eyelid gradually drooped, and you are concerned about tearing, dryness, irritation or appearance - make an appointment for a scheduled consultation.
05 / DIAGNOSTICSAs defined,
As defined,
that pulls the eyelid.
- Conversation
When the eyelid began to droop; whether there were injuries, burns, operations on the eyelids, paralysis of the facial nerve; what drops you instill.
- Examination of the eyelids
Simple tests: the eyelid is pulled back and seen how quickly it returns. This is how it is assessed whether it is stretched or pulled by a scar.
- Eye examination
Is the cornea not damaged or inflamed; if necessary, consult an ophthalmologist.
- Photo in standard angles
For operation planning and comparison.
06 / TREATMENTHow we treat
How we treat
ectropion
If symptoms are mild, treatment may not be necessary. When ectropion gives severe symptoms, surgery helps. It is selected according to the cause and location of the inversion, combining several techniques.
01
Eye protection
While waiting for an examination or surgery.
- Hydration
- Eye drops or ointment to keep the eye from drying out.
- Sealing the eyelids
- If the eye does not close, it must be protected: the doctor will show how to glue the eyelids with a special patch.
- Do not rub your eyes
- Frequent wiping and rubbing can aggravate ectropion. It is better to carefully wipe the tears with a clean napkin.
02
Surgery
The method depends on what exactly pulls the eyelid.
- The eyelid stretched
- It is shortened and fixed to the outer corner of the eye - this is a lateral tarsal strip, the most common operation for age-related ectropion. In a series of 85 eyelids, the success rate was 95%, a repeat operation was performed on four eyelids.
- scar
- The scar is dissected or excised, and the lack of skin is filled with a skin graft or local tissues. In a review of 31 studies (299 patients), surgery completely corrected cicatricial ectropion in 79%.
- Paralysis
- The eyelid is pulled up or suspended on a strip of the own fascia of the thigh. In a study of 79 patients, both methods reduced exposure of the white of the eye, and suspension produced a symmetrical result without shifting the inner corner of the eyelid to the side or down.
- Neoplasms
- It is removed and, if necessary, the eyelid is restored.
03
Outcome and risks
- Relapse
- After any technique, ectropion can return. In a study of 100 patients after operations on the lower eyelid, the violation of its position returned in 12% and 18% in two groups.
- The first days
- Tearing, pain, bleeding wounds and swelling are possible; in a series of 85 eyelids, the majority of such phenomena passed within a week without treatment.
- If it is not possible to operate
- With cicatricial ectropion, injections of hyaluronic acid are possible: the appearance is better, but the ectropion returns more often than after surgery.
- After burns
- According to a review of studies, early treatment of ectropion after a burn produces better results.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Ectropion at Dr. Valikhnovskyi's Institute of Surgery is treated in the direction of "New Face" - together with scars that tighten the eyelids and the consequences of paralysis of the facial nerve. The clinic is responsible for eyelid surgery; if the cornea or conjunctiva are damaged, they are treated by an ophthalmologist.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- Lateral tarsal stripe — the stretched eyelid is shortened and fixed to the outer corner of the eye.
- Canthopexy and canthoplasty - strengthen or restore the outer corner of the eye, so that the eyelid fits tightly to the eye again.
- Transplants and spacers — if the eyelid is pulled by a scar, it is excised, and the lack of tissue is filled with local tissues, a skin or cartilage graft, or a spacer.
- Mesh materials — in difficult cases, a mesh implant gives the lower eyelid additional support.
- Static operations for paralysis — with long-term paralysis of the facial nerve, the symmetry of the face at rest is improved.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
Publications by topic
- An article on the treatment of ectropion of the lower eyelid with polypropylene mesh materials — Bukovynsky Medical Bulletin, 2025 (DOI).
How treatment works with us
- Photo onlineSend a photo of the eyes directly and from the side - the doctor will first assess the situation.
- ConsultationExamination of the eyelids and eye, finding out the cause; if necessary, consult an ophthalmologist.
- PlanWhat exactly is pulling the eyelid - stretch, scar or paralysis - and how to fix it.
- SurgeryTechniques are selected according to the reason, often combining several.
- RecoveryThe first days — swelling and lacrimation; the doctor will explain how to care for the eye and when to come for an examination.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Can ectropion be cured without surgery?
Eye drops, ointment, and adhesives are needed to protect the eye. If symptoms are mild, treatment may not be necessary. If ectropion gives severe symptoms, it is corrected by surgery.
Why does ectropion appear with age?
As we age, the tissues around the eye weaken and the lower eyelid stretches and droops. In a survey of 24,565 elderly people, 2.9% had age-related ectropion, more often in men than in women.
Can ectropion appear after blepharoplasty?
Yes. Complications of blepharoplasty and other operations on the eyelids are one of the causes of cicatricial ectropion.
What will happen if ectropion is not treated?
Repeated inflammation of the conjunctiva and cornea, erosion of the cornea, and in severe cases — its perforation and loss of vision are possible.
Can ectropion return after surgery?
Maybe: there is a risk of relapse after any technique. In a study of 100 patients after operations on the lower eyelid, the disorder of its position returned in 12–18%.
What to do if the operation is contraindicated?
The eye is protected with drops and ointment. In cicatricial ectropion, hyaluronic acid injections are possible: in a review of studies, they completely corrected ectropion in 63% of patients versus 79% after surgery, but more often gave a recurrence.
Do you need an ophthalmologist?
So, if the eye is red, hurts or vision has worsened: the condition of the cornea and conjunctiva is evaluated by an ophthalmologist. The surgeon corrects the position of the eyelid.
Sources
14 sources · reviews, guidelines and researchshowCollapse
- EctropionTidsskrift for Den norske legeforening, 2024doi:10.4045/tidsskr.23.0309 ↗
- EctropionSeminars in Ophthalmology, 2010doi:10.3109/08820538.2010.488570 ↗
- Involutional entropion and ectropion of the lower eyelid: prevalence and associated risk factors in the elderly populationOphthalmic Plastic and Reconstructive Surgery, 2011doi:10.1097/IOP.0b013e3182115229 ↗
- Involutional ectropion: etiological factors and therapeutic managementInternational Ophthalmology, 2023doi:10.1007/s10792-022-02475-3 ↗
- Lateral tarsal strip procedure for involutional ectropion: A retrospective analysis of 85 cases and a comprehensive literature reviewAdvances in Ophthalmology Practice and Research, 2021doi:10.1016/j.aopr.2021.100004 ↗
- Evaluation of outcomes of lower eyelid entropion and ectropion surgical repairPolski Przeglad Chirurgiczny, 2023doi:10.5604/01.3001.0053.9352 ↗
- Approach to treatment of cicatricial ectropion: a systematic review and meta-analysis comparing surgical and minimally invasive optionsArchives of Dermatological Research, 2020doi:10.1007/s00403-019-01983-0 ↗
- Ectropion Repair Techniques and the Role of Adjunctive Superotemporal Skin Transposition for Tarsal EctropionJournal of Clinical Medicine, 2025doi:10.3390/jcm14030827 ↗
- Lateral Tarsal Strip versus Tensor Fascia Lata Sling for Paralytic Ectropion: Comparison and Long-Term OutcomesPlastic and Reconstructive Surgery, 2024doi:10.1097/PRS.0000000000010533 ↗
- Clinical practice guideline: Bell's palsyOtolaryngology–Head and Neck Surgery, 2013doi:10.1177/0194599813505967 ↗
- Interventions for Functional and Cosmetic Outcomes Post Burn for Eyelid Ectropion — A Scoping ReviewEuropean Burn Journal, 2025doi:10.3390/ebj6030046 ↗
- EctropionNHS, 2025nhs.uk/conditions/ectropion ↗
- Vision lossNHS, 2025nhs.uk/conditions/vision-loss ↗
- Treatment of lower eyelid ectropion using polypropylene mesh materialsBukovyna Medical Bulletin, 2025doi:10.24061/2413-0737.29.2.114.2025.14 ↗
The figures on the page are from these sources.
The eyelid drooped
does the eye water?
Send a photo of your eyes. The doctor will tell you what caused the ectropion and how it can be corrected.