The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Ectropion is a condition in which the eyelid becomes slack and turns outwards so that it is no longer in contact with the eyeball. It usually affects the lower eyelid, and occurs in around 0.3% of the population under 60, rising to around 16.7% of those aged 80 or over. Symptoms vary with severity but affected eyes can become sore, red and watery. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating ectropion. It highlights non-pharmacological management and pharmacological treatment options, and outlines when referral is appropriate.
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What is ectropion?
Ectropion is a condition in which the eyelid (usually the lower eyelid) becomes slack and is no longer in contact with the eyeball. The commonest cause is loss of elasticity and muscle tone of the eyelids which happens as part of the ageing process. The affected eye becomes sore, red and watery.
How is ectropion managed?
Patients may be helped by artificial tears and unmedicated ointments. If the eye does not close fully at night, it may need to be taped shut. Sometimes a bandage contact lens is fitted to protect the eye surface from drying. If these measures do not help, one of a number of possible surgical operations, usually carried out under local anaesthetic, may solve the problem.
Ectropion - 15 September 2025 The aetiology section has been amended to include up to date data on the prevalence of ectropion and information on the risk factors for the development of involutional ectropion. The predisposing factors section has been updated to include additional risk factors for the development of ectropion in general. Under the signs section, a detailed description of the distraction test to assess medial canthal tendon laxity has now been provided.
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