Ectropion occurs when the eyelid margin is rotated interiorly with separation of the lower lid margin from the globe, predisposing the patient to have epiphora and corneal exposure problems.

Ectropion may result from scar formation, lax lower eyelid, or resection of too much skin. The most important treatment is prevention. Preoperative recognition of predisposing factors such as the lax lower eyelid, proptosis, unilateral high myopia, and thyroid disease is important. In these patients conservative removal of skin, muscle, and fat is important.

Initial treatment of ectropion is conservative consisting of eyelid massage and local steroid injection. The massage is performed by pushing the upper eyelid up and holding it up for 10 seconds ten times a day. If conservative management fails to resolve the ectropion, surgical management is indicated. For the lax lower eyelid a wedge resection or tarsal strip procedure may be performed. If ectropion results from excess skin resection, a skin graft is performed. Resected skin may be banked for up to 3 weeks for reinsertion. After this time, skin may be grafted from the upper eyelids.