This guideline last updated 06/05/2022 17:39:35

Differential diagnosis

• Facial nerve palsy
• Stroke
• Thyroid eye disease
• Lid tumour
• Cicatrisation following solar damage, trauma, radiotherapy, burn, dermatitis

Possible management by Optometrist

Treatment

• Ocular lubricants for tear deficiency/instability related symptoms (drops for use during the day, unmedicated ointment for use at bedtime)
• Tape the lids closed at night when there is a risk of corneal exposure is indicated (assuming the ectropion will close; i.e. not cicatricial)

Advice

• Mild cases require no treatment
• Advise that lid rubbing may increase lid laxity

Management Category

Mild asymptomatic involutional cases

• Normally no referral unless cicatricial
• Monitor for deterioration

More severe cases possibly requiring surgery

• Routine referral

Possible management by Ophthalmologist

• Surgery, choice determined by nature, position and degree of ectropion
• Occasionally tarsorraphy for paralytic ectropion