Causes of Ectropion
The causes of ectropion are varied, but the condition most commonly results from age-related changes in the tissues and muscles around the eye. As we age, the connective tissues supporting the eyelids lose elasticity and tone, causing the lower eyelid to sag and turn outward. This form is known as involutional ectropion and is the most frequent type seen in clinical practice.
Another significant cause is facial nerve paralysis, particularly of the seventh cranial nerve, also known as the facial nerve. When this nerve is damaged—due to Bell’s palsy, stroke, or head trauma—it affects the muscles that hold the eyelid in place. As a result, the eyelid can droop outward, leading to paralytic ectropion.
Scarring from previous surgeries, burns, trauma, or chronic eye infections can pull the eyelid outward. This is known as cicatricial ectropion. Inflammation or damage to the skin and tissues around the eye alters the normal structure, preventing the eyelid from sitting properly against the eye.
Chronic allergic reactions or infections can also cause the eyelid to swell and lose its normal positioning over time. In rare cases, tumours near the eye can push the eyelid outwards, creating mechanical ectropion.
Certain congenital conditions—present from birth—may also lead to ectropion. Although rare, babies born with eyelid deformities may experience symptoms early in life, requiring specialist care and sometimes surgery.
Causes of Ectropion
In South Africa, trauma and burns are significant contributors to ectropion, particularly in rural or low-income areas where open cooking fires and untreated skin infections are more common. Lack of access to prompt treatment can result in scar formation, increasing the risk of cicatricial ectropion.
Long-term use of certain eye medications can also contribute to tissue changes around the eyelid. Prolonged irritation may weaken the eyelid’s structure and lead to eventual outward turning.
Regardless of the cause, early recognition and treatment are key. Left untreated, ectropion can lead to chronic discomfort, tearing, and even permanent damage to the eye surface. Understanding the causes of ectropion allows for prevention in some cases and supports faster intervention in others.
[Next: Symptoms of Ectropion →]
