Definitive management is surgical. Medical management is temporizing but can improve symptoms while awaiting surgery.
Deferral of surgery should be considered in 2 groups of patients. Ectropion induced by long-term use of eye drops such as dorzolamide and brimonidine may resolve with discontinuation, if feasible. Patients suffering from inflammatory skin conditions involving the eyelid may have improvement or reversal of ectropion with improved control of inflammation.
- Lubrication of the ocular surface
- Horizontal taping of the eyelid
- Lower eyelid laxity: the lower eyelid is horizontally tightening by a lateral tarsal strip or similar procedure.
- Lower eyelid retractor disinsertion: the Jones procedure reattaches retractors to the tarsus.
- Punctual ectropion: the medical spindle procedure reapposes the everted punctum.
- Cicatricial ectropion often requires lengthening of the anterior lamella by a skin graft.
- Paralytic ectropion requires horizontal tightening and correction of punctal ectropion. With facial nerve paralysis, corneal exposure and brow ptosis may also need to be addressed.