What is ectropion and how is it treated?
Ectropion is an outward turning of the lower eyelid margin. When the eyelid no longer sits flush against the eye, the tear film is disrupted, the lower punctum (the tear drainage opening) rotates away from the ocular surface, and the conjunctiva becomes exposed to the air — causing chronic tearing, redness, irritation and mucoid discharge.
The most common form is involutional ectropion, caused by age-related horizontal laxity of the lower eyelid's supporting structures. As the tarsoligamentous sling loosens, the eyelid margin gradually turns outward. In many cases, the eyelid appears simply red and irritated before the outward turning becomes obvious.
Other causes include paralytic ectropion (facial nerve palsy reducing muscle tone), cicatricial ectropion (scarring of the eyelid skin pulling the margin down), and mechanical ectropion (a mass displacing the eyelid).
Surgical correction depends on the type. For involutional ectropion the eyelid is tightened horizontally — most commonly via a lateral tarsal strip procedure. Cicatricial ectropion often requires lengthening of the scarred skin, sometimes with a skin graft. Paralytic ectropion requires both tightening and treatment of any corneal exposure.
Persistent watery, red or irritated eyes? Have your lower eyelids assessed by Dr. Alia Issa.
Signs and symptoms — who is a candidate?
Ectropion is often underdiagnosed. If you have persistent tearing or a chronically red eye, a specialist assessment is important. Common symptoms include:
- Persistent tearing — tears overflow because the punctum is no longer in contact with the tear lake
- Chronic redness of the eye and visible palpebral conjunctiva
- A gritty or foreign-body sensation from ocular surface exposure
- Mucoid discharge collecting at the inner corner of the eye
- Visible outward turning of the lower eyelid margin
- Recurrent eye infections or conjunctivitis
Dr. Issa performs a detailed examination of lower eyelid laxity (including distraction and snap-back tests), facial nerve function, ocular surface, and the position of the lower punctum. Treatment is tailored to the type and severity identified.
How the procedure works — before, during and after
Every case is individual. The following is a general outline of what patients can expect.
Dr. Issa examines lower eyelid position, assesses horizontal laxity, evaluates the lower punctum position, and examines the cornea for any exposure-related changes. The type of ectropion is identified and a surgical plan is made.
Ectropion repair is performed as a day case under local anaesthesia. For involutional ectropion, the lateral tarsal strip procedure tightens the lower eyelid and repositions the lateral canthus. The procedure typically takes 30–60 minutes.
Bruising and swelling generally settle within 7–10 days. Many patients notice an improvement in tearing early on. Sutures are usually removed at 7–10 days.
The eyelid typically settles into its new position by 4–6 weeks. Relief from tearing, irritation and redness is often noticeable. Any surface changes tend to improve with lubrication as the exposure is corrected.
Why choose an oculoplastic surgeon for ectropion repair?
Because ectropion affects tear drainage and the ocular surface, correction should protect the cornea while repositioning the lid. An oculoplastic surgeon assesses eyelid laxity, punctal position and corneal health together — so treatment addresses both the comfort of the eye and the appearance of the lid.
If you also have an eyelid lump or other lid concern, see our Journal guide to chalazion removal in Dubai, or explore related procedures below.
Frequently asked questions
What is ectropion?
Ectropion is an outward turning of the lower eyelid margin. When the eyelid no longer contacts the eye, it causes tearing, irritation, redness and, if untreated, corneal damage. Surgery is the definitive treatment.
What causes ectropion?
The most common cause is involutional — age-related laxity of the lower eyelid's supporting structures. Other causes include facial nerve palsy (paralytic ectropion), scarring of the eyelid skin (cicatricial ectropion), and mechanical displacement by an eyelid mass.
How is ectropion repaired?
For the most common involutional ectropion, the lower eyelid is tightened horizontally — most often via a lateral tarsal strip procedure. The technique varies depending on the cause and severity, which Dr. Issa assesses at consultation.
What are the symptoms of ectropion?
Persistent tearing, a red or irritated eye, mucoid discharge, a gritty sensation, and visible outward turning of the lower eyelid margin. Left untreated, ectropion can lead to corneal problems, so timely assessment matters.
What is the recovery from ectropion repair?
Ectropion repair is a day case under local anaesthesia. Many patients return to daily activities within 7–10 days, and the eyelid position is generally improved early after surgery. Individual recovery varies.
Can ectropion recur after surgery?
Recurrence is possible, particularly in patients with very lax eyelids or an ongoing cause such as facial palsy. Dr. Issa discusses the likelihood of recurrence and the best approach to reduce it at consultation.
Book your ectropion repair consultation in Dubai with Dr. Alia Issa.