Ektropion
Epidemiologia

Ektropion powieki, najczęściej dolnej, charakteryzuje się wywinięciem brzegu powieki na zewnątrz, co prowadzi do braku kontaktu z gałką oczną. Częstość występowania ektropionu wzrasta wraz z wiekiem, osiągając 16,7-17% u osób powyżej 80 lat, a inwolucyjny ektropion dotyka 2-3% populacji senioralnej. Czynniki ryzyka obejmują podeszły wiek, nadciśnienie tętnicze (zwiększające ryzyko o 46-50%), dyslipidemię (45-46%), cukrzycę, palenie tytoniu, udar mózgu oraz choroby autoimmunologiczne reumatyczne (zwiększające ryzyko o 43-90%). Ektropion wiąże się z lokalnymi chorobami zapalnymi powiek, takimi jak blepharitis (OR 4,25-4,66), gradówka (OR 2,94-3,01), jęczmień (OR 2,26-2,27) oraz zapalenie skóry powiek (OR 1,69-2,46). Ponadto, choroby powierzchni oka, jak przewlekłe zapalenie spojówek (OR 2,89-3,49) i skrzydlik (OR 2,21-2,48), również zwiększają ryzyko rozwoju ektropionu. Lokalny niedobór immunologiczny w obrębie powiek, manifestujący się zmniejszeniem populacji limfocytów CD4, CD8 i CD1, może upośledzać odpowiedź immunologiczną i sprzyjać patogenezie schorzenia.

Epidemiologia Ektropionu

Ektropion (wywinięcie powieki) jest jednym z najczęściej spotykanych zaburzeń powiek w okulistyce i stanowi najczęstszą formę nieprawidłowego położenia powieki.12 W tym schorzeniu brzeg powieki, zazwyczaj dolnej, jest odwrócony na zewnątrz, przez co nie pozostaje w kontakcie z gałką oczną.3 Występowanie ektropionu jest zróżnicowane w zależności od wieku pacjentów oraz typu schorzenia.

Częstotliwość występowania wg grup wiekowych

Częstość występowania ektropionu zwiększa się znacząco wraz z wiekiem, co wynika głównie z procesu starzenia się i utraty elastyczności tkanek powiek:45

  • U osób poniżej 60 roku życia – około 0,3% populacji
  • W wieku 60-69 lat – około 1% populacji
  • W wieku 70-79 lat – około 7% populacji
  • W wieku 80 lat i więcej – od 16,7% do 17% populacji

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Występowanie inwolucyjnego ektropionu dolnej powieki u pacjentów w podeszłym wieku szacuje się na poziomie do 2%.8 Natomiast ektropion inwolucyjny jako relatywnie powszechna przypadłość związana z wiekiem dotyka 2% do 3% populacji osób starszych.9

Różnice w występowaniu ze względu na płeć

W większości typów ektropionu nie obserwuje się istotnych różnic w występowaniu między płciami:10

  • Ektropion inwolucyjny – większa częstość występowania u mężczyzn, szczególnie w wieku powyżej 80 lat111213
  • Ektropion porażenny – równomierne występowanie u mężczyzn i kobiet14
  • Ektropion bliznowaty – równomierne występowanie u mężczyzn i kobiet, choć niektóre badania wskazują na wyższy odsetek mężczyzn (70%) wśród pacjentów wymagających przeszczepów skóry o pełnej grubości15

Czynniki ryzyka ektropionu

Zidentyfikowano szereg czynników predysponujących do rozwoju ektropionu:16

  • Podeszły wiek – główny czynnik ryzyka, związany z utratą elastyczności i napięcia mięśniowego powiek1718
  • Nadciśnienie tętnicze – zwiększa ryzyko o około 46-50%1920
  • Dyslipidemia – zwiększa ryzyko o około 45-46%2122
  • Cukrzyca23
  • Palenie tytoniu24
  • Udar mózgu25
  • Historia raka skóry i wrażliwość na słońce26
  • Choroby autoimmunologiczne reumatyczne – zwiększają ryzyko o około 43-90%2728

Ektropion a choroby zapalne

Badania wykazały istotne związki między ektrionem a różnymi przewlekłymi i układowymi chorobami zapalnymi, które wpływają na powieki i powierzchnię oka.29

Zapalne choroby powiek związane z ektrionem

Wykryto znaczące powiązania między ektropionem inwolucyjnym a lokalnymi chorobami zapalnymi powiek:3031

Schorzenie Iloraz szans (OR) Zwiększenie ryzyka
Zapalenie brzegów powiek (blepharitis) 4,25-4,66 3-4 krotne zwiększenie ryzyka
Gradówka (chalazion) 2,94-3,01 około 3-krotne zwiększenie ryzyka
Jęczmień (hordeolum) 2,26-2,27 ponad 2-krotne zwiększenie ryzyka
Zapalenie skóry powiek (dermatitis) 1,69-2,46 1,7-2,5 krotne zwiększenie ryzyka

3233

Choroby powierzchni oka związane z ektriopionem

Zidentyfikowano również choroby powierzchni oka, które są powiązane z rozwojem ektropionu:3435

  • Przewlekłe zapalenie spojówek – zwiększa ryzyko 2,4-3,5 krotnie (OR 2,89-3,49)3637
  • Skrzydlik (pterygium) – zwiększa ryzyko około 2,2-2,5 krotnie (OR 2,21-2,48)3839

Związek z zaburzeniami immunologicznymi

Badania wskazują, że w przypadku ektropionu może występować lokalny niedobór immunologiczny, który upośledza nadzór immunologiczny i odpowiedź komórkową:40

Monitorowanie i nadzór nad ektrionem

Odpowiednie badanie powiek powinno być przeprowadzone przed wszystkimi rodzajami operacji okołogałkowych. Pozwoli to określić ryzyko pooperacyjnego ektropionu i umożliwi uwzględnienie elementów kompensacyjnych podczas planowania operacji.43

Ocena ryzyka i wczesne wykrywanie

Wczesne wykrycie ektropionu ma istotne znaczenie dla efektywnego zarządzania tym schorzeniem:44

  • Badanie fizykalne i badanie w lampie szczelinowej mogą być wykorzystane do skutecznej oceny wyglądu ektropionu i jego potencjalnej progresji45
  • Ocena czynników ryzyka i współistniejących chorób pozostaje cenna w zmniejszaniu częstości progresji ektropionu46
  • Wczesne wykrycie może odgrywać rolę w zachowawczym leczeniu ektropionu, co często prowadzi do poprawy wyników47

Obserwacja po zabiegach chirurgicznych

Szczególnej uwagi wymaga monitorowanie pacjentów po zabiegach chirurgicznych w okolicy oka:48

  • Ektropion bliznowaty może pojawić się po wycięciu zmian, a następnie pierwotnym zamknięciu lub bardziej złożonej rekonstrukcji powieki49
  • Częstość występowania ektropionu po wycięciu guza dolnej powieki wynosi od 2,5% do 7%, a po przeszczepie skóry pełnej grubości – 14,2%50
  • Ektropion jest zwykle zauważalny około jeden do dwóch miesięcy po zabiegu51
  • Rany o większej średnicy, szczególnie te przekraczające 21 mm, częściej prowadzą do rozwoju ektropionu52
  • Inne czynniki przyczyniające się do rozwoju ektropionu obejmują obkurczenie przeszczepu i infekcję53

Specyficzne rodzaje ektropionu i ich epidemiologia

Ektropion szyjki macicy

Ektropion szyjki macicy jest jednym z najczęściej spotykanych stanów ginekologicznych. Jego częstość występowania waha się między 17% a 50%.54 Rozpowszechnienie zwiększa się wraz z liczbą porodów, ale zmniejsza po 35 roku życia.55

  • Może występować nawet u 80% aktywnych seksualnie nastolatek56
  • Częstość występowania zależy również od rodzaju stosowanej antykoncepcji – jest częściej spotykany u kobiet stosujących doustne tabletki antykoncepcyjne, a rzadziej u kobiet stosujących barierowe metody antykoncepcji5758
  • W Bengazi (Libia) 54,9% kobiet stosujących doustne tabletki antykoncepcyjne i wewnątrzmaciczne wkładki miedziane ma ektropion szyjki macicy59
  • W Chinach 43,2% kobiet zgłasza się z ektriopionem szyjki macicy60
  • Występuje u około 29% wcześniaków płci żeńskiej i 68% niemowląt w pierwszym miesiącu życia z powodu przeniesienia estrogenu matki przez łożysko61

Nabyty ektropion błony naczyniowej

Nabyty ektropion błony naczyniowej (Acquired Ectropion Uveae – AEU) jest znacznie częściej spotykany niż jego wrodzona odmiana, a rozpowszechnienie AEU różni się w zależności od przyczyny podstawowej:62

  • Najczęściej występuje w stadium zamykania kąta jaskry neowaskularnej i u pacjentów z jaskrą absolutną (niekontrolowany wzrost ciśnienia wewnątrzgałkowego)63
  • W przypadku czerniaka tęczówki, badanie retrospektywne przeprowadzone przez Shields i wsp. na przestrzeni 40 lat zidentyfikowało ektropion błony naczyniowej u 24 z 317 pacjentów (7,6%)64
  • W przypadkach rozlanego czerniaka tęczówki rozpowszechnienie jest jeszcze wyższe – w jednym badaniu stwierdzono 21 z 25 pacjentów (84%) z współistniejącym ektrionem błony naczyniowej65
  • Niedrożność żyły środkowej siatkówki (CRVO) jest kolejną częstą przyczyną AEU, przy czym aż 60% przypadków niedokrwiennego CRVO jest związanych z neowaskularyzacją tęczówki i AEU66
  • Zespół ICE (irydokorneoendotelialny) często prowadzi do AEU – retrospektywna analiza obejmująca 144 przypadki zespołu ICE wykazała, że około jednej czwartej (24,6%) tych pacjentów rozwija AEU, szczególnie częsty w zespole Cogana-Reese’a (54,2%, 13 z 24 przypadków)67

Ektropion w ichtiozach

Ichtiozopodobne dermatozy to grupa dziedzicznych zaburzeń charakteryzujących się suchością i szorstkością skóry z nadmiernym nagromadzeniem łusek naskórkowych.68

  • Rybia łuska blaszkowata jest najrzadszą postacią, z częstością występowania 1 na 300 00069
  • Objawy oczne obejmują zapalenie rogówki związane z ekspozycją wtórną do ektropionu, jednostronną megalokornę, powiększony nerw rogówkowy, zapalenie brzegów powiek, brak gruczołu Meiboma, nieprawidłowe ustawienie rzęs, brak rzęs i brak punktów łzowych70
  • Udokumentowano ektropion zarówno górnej, jak i dolnej powieki71

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Involutional ectropion
    https://webeye.ophth.uiowa.edu/eyeforum/cases/218-ectropion.htm
    Ectropion is one of the most commonly encountered eyelid disorders seen in ophthalmology. […] One of the most common oculoplastic disorders of the eyelids.
  • #2 Ectropion in Dermatologic Surgery: Exploration and Reconstruction Techniques | Actas Dermo-Sifiliográficas
    https://actasdermo.org/en-ectropion-in-dermatologic-surgery-exploration-articulo-S1578219020300251
    Ectropion, or eyelid eversion, is the most common form of eyelid malposition. By impairing the eyelids protective function, ectropion can cause epiphora, lagophthalmos, keratinization, chronic irritation, pain, and ulceration. There are 5 types of ectropion, each with a different cause: congenital, paralytic, involutional, cicatricial, and mechanical. The most common presentation in dermatology is involutional eversion with a mechanical or tractional element. Several options exist for the surgical repair of ectropion and choice of technique will depend on the main pathogenic component. We review the basic anatomy of the eyelid and describe examination techniques for assessing risk and preventing ectropion and for identifying the main pathogenic component in order to select the most suitable repair technique.
  • #3 Ectropion – College of Optometrists
    https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/ectropion
    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. […] This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating 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. […] If these measures do not help, one of a number of possible surgical operations, usually carried out under local anaesthetic, may solve the problem.
  • #4 Ectropion | Tidsskrift for Den norske legeforening
    https://tidsskriftet.no/en/2024/01/clinical-review/ectropion
    In ectropion, the eyelid margin typically the lower eyelid is turned outward. This condition is becoming increasingly common due to the ageing population. Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional, paralytic, mechanical and cicatricial subtypes. Involutional ectropion is the most common where there is no patient population bias. […] Age is the primary risk factor for the development of ectropion, and the prevalence increases with age. It has been reported that 1 % of people aged 6069 years have ectropion, which increases to 7 % for ages 7079 years and up to 17 % among those aged 80 and over. The prevalence is higher in men than women. […] Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional (age-related), paralytic, mechanical and cicatricial (scar-related) subtypes. This clinical review provides an overview of the condition and is based on a selective review of the literature and the authors’ experiences in clinical practice.
  • #5 Ectropion – College of Optometrists
    https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/ectropion
    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. […] This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating 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. […] If these measures do not help, one of a number of possible surgical operations, usually carried out under local anaesthetic, may solve the problem.
  • #6 Ectropion | Tidsskrift for Den norske legeforening
    https://tidsskriftet.no/en/2024/01/clinical-review/ectropion
    In ectropion, the eyelid margin typically the lower eyelid is turned outward. This condition is becoming increasingly common due to the ageing population. Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional, paralytic, mechanical and cicatricial subtypes. Involutional ectropion is the most common where there is no patient population bias. […] Age is the primary risk factor for the development of ectropion, and the prevalence increases with age. It has been reported that 1 % of people aged 6069 years have ectropion, which increases to 7 % for ages 7079 years and up to 17 % among those aged 80 and over. The prevalence is higher in men than women. […] Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional (age-related), paralytic, mechanical and cicatricial (scar-related) subtypes. This clinical review provides an overview of the condition and is based on a selective review of the literature and the authors’ experiences in clinical practice.
  • #7 Ectropion – College of Optometrists
    https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/ectropion
    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. […] This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating 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. […] If these measures do not help, one of a number of possible surgical operations, usually carried out under local anaesthetic, may solve the problem.
  • #8 Ectropion – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/sites/books/NBK441929/
    The prevalence of involutional lower lid ectropion in elderly patients has been reported as high as 2%. It may be associated with trauma. […] Morbidity is primarily associated with corneal/conjunctival exposure.
  • #9 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #10 Eyelid Malpositions | Ento Key
    https://entokey.com/eyelid-malpositions/
    Epidemiology and Etiology Age: More common in older patient population Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: More common in older patient population Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: Any age Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: Any age Gender: More common in males because of higher incidence of traumatic events […] Epidemiology and Etiology Age: Older patients Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: Any age Gender: More frequent in women
  • #11 Ectropion | Tidsskrift for Den norske legeforening
    https://tidsskriftet.no/en/2024/01/clinical-review/ectropion
    In ectropion, the eyelid margin typically the lower eyelid is turned outward. This condition is becoming increasingly common due to the ageing population. Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional, paralytic, mechanical and cicatricial subtypes. Involutional ectropion is the most common where there is no patient population bias. […] Age is the primary risk factor for the development of ectropion, and the prevalence increases with age. It has been reported that 1 % of people aged 6069 years have ectropion, which increases to 7 % for ages 7079 years and up to 17 % among those aged 80 and over. The prevalence is higher in men than women. […] Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional (age-related), paralytic, mechanical and cicatricial (scar-related) subtypes. This clinical review provides an overview of the condition and is based on a selective review of the literature and the authors’ experiences in clinical practice.
  • #12 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #13 Arquivos Brasileiros de Oftalmologia – Eyelid aging: pathophysiology and clinical management
    https://www.aboonline.org.br/details/2117/en-US/eyelid-aging–pathophysiology-and-clinical-management
    Dermatochalasis, ptosis, ectropion, and entropion are common disorders in middle-aged and older adults. The overall prevalence of sagging eyelids among individuals aged 45 years is reported to be 16%, comprising 19% of men and 14% of women. Two large epidemiologic studies – the Rotterdam study and the Twins UK study – dealt with the prevalence and risk factors for sagging eyelids. By studying these populations, many non-genetic risk factors for sagging eyelids could be discerned, including age, high body mass index, lighter skin color, smoking, male gender, and heritability. Genetic analysis showed the C allele of rs11876749 on chromosome 18 to be a defensive risk factor for sagging eyelids. […] The prevalence of involutional ectropion seems to be similar to that of involutional entropion. The literature suggests that the prevalence of ectropion is about 4% in patients older than 49 years, not differing among the different ectropion forms or regarding the underlying etiology. This involutional malformation is the most common form of ectropion and entropion. Males are more often affected by involutional ectropion. In contrast, involutional entropion is more often seen in women. The involutional forms of ectropion and entropion affect whites more often than blacks. The prevalence of involutional ectropion and entropion increases with the patient’s age, which is the logical order for involutional malformations to increase with age.
  • #14 Eyelid Malpositions | Ento Key
    https://entokey.com/eyelid-malpositions/
    Epidemiology and Etiology Age: More common in older patient population Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: More common in older patient population Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: Any age Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: Any age Gender: More common in males because of higher incidence of traumatic events […] Epidemiology and Etiology Age: Older patients Gender: Equal occurrence in males and females […] Epidemiology and Etiology Age: Any age Gender: More frequent in women
  • #15 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion
    https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en
    Cicatricial ectropion may be a consequence of certain systemic diseases as well as the result of drug use. […] A detailed PubMed literature search indicated many different etiologies were associated with cicatricial ectropion development, from severe cases of systemic diseases, such as ichthyosis and lupus erythematosus, to reversible scenarios secondary to anti-glaucomatous drug use. […] Indeed, cicatricial ectropion may be highly symptomatic; being able to determine its real etiology is imperative to managing patients properly. […] A recent report on cicatricial ectropion demographics in 145 patients requiring full-thickness skin grafts showed a mean age of 75, 70% male, and 90% Caucasian (self-reported). […] For 35% of these cases, the cause was unknown; however, another 35% had a previous transcutaneous lower eyelid blepharoplasty, 20% had a surgical history of lower eyelid or midface reconstruction after Mohs surgery, and 10% had experienced some type of earlier trauma.
  • #16 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #17 Ectropion | Tidsskrift for Den norske legeforening
    https://tidsskriftet.no/en/2024/01/clinical-review/ectropion
    In ectropion, the eyelid margin typically the lower eyelid is turned outward. This condition is becoming increasingly common due to the ageing population. Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional, paralytic, mechanical and cicatricial subtypes. Involutional ectropion is the most common where there is no patient population bias. […] Age is the primary risk factor for the development of ectropion, and the prevalence increases with age. It has been reported that 1 % of people aged 6069 years have ectropion, which increases to 7 % for ages 7079 years and up to 17 % among those aged 80 and over. The prevalence is higher in men than women. […] Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional (age-related), paralytic, mechanical and cicatricial (scar-related) subtypes. This clinical review provides an overview of the condition and is based on a selective review of the literature and the authors’ experiences in clinical practice.
  • #18 Ectropion – College of Optometrists
    https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/ectropion
    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. […] This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating 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. […] If these measures do not help, one of a number of possible surgical operations, usually carried out under local anaesthetic, may solve the problem.
  • #19 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    We found a strong association between periocular and ocular surface inflammatory diseases and involutional ectropion. […] Chronic conjunctivitis and pterygium were identified as risk factors for the development of ectropion, with chronic conjunctivitis increasing the risk by 2.4 times compared to control group M1 and by 2.9 times compared to control group M2. […] The present study identified statistically significant associations between involutional ectropion and both hypertension and dyslipidemia, suggesting that these cardiovascular risk factors may contribute to the development of paralytic ectropion. […] Additionally, we report statistically significant associations between ectropion and autoimmune rheumatic diseases, the precise mechanisms connecting inflammatory systemic diseases to ocular ectropion remain unclear. […] This study provides compelling evidence that various inflammatory conditions affecting the eyelids and the ocular surface, as well as systemic inflammatory diseases, significantly increase the risk of developing ectropion.
  • #20 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #21 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    We found a strong association between periocular and ocular surface inflammatory diseases and involutional ectropion. […] Chronic conjunctivitis and pterygium were identified as risk factors for the development of ectropion, with chronic conjunctivitis increasing the risk by 2.4 times compared to control group M1 and by 2.9 times compared to control group M2. […] The present study identified statistically significant associations between involutional ectropion and both hypertension and dyslipidemia, suggesting that these cardiovascular risk factors may contribute to the development of paralytic ectropion. […] Additionally, we report statistically significant associations between ectropion and autoimmune rheumatic diseases, the precise mechanisms connecting inflammatory systemic diseases to ocular ectropion remain unclear. […] This study provides compelling evidence that various inflammatory conditions affecting the eyelids and the ocular surface, as well as systemic inflammatory diseases, significantly increase the risk of developing ectropion.
  • #22 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #23 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #24 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #25 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #26 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #27 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    We found a strong association between periocular and ocular surface inflammatory diseases and involutional ectropion. […] Chronic conjunctivitis and pterygium were identified as risk factors for the development of ectropion, with chronic conjunctivitis increasing the risk by 2.4 times compared to control group M1 and by 2.9 times compared to control group M2. […] The present study identified statistically significant associations between involutional ectropion and both hypertension and dyslipidemia, suggesting that these cardiovascular risk factors may contribute to the development of paralytic ectropion. […] Additionally, we report statistically significant associations between ectropion and autoimmune rheumatic diseases, the precise mechanisms connecting inflammatory systemic diseases to ocular ectropion remain unclear. […] This study provides compelling evidence that various inflammatory conditions affecting the eyelids and the ocular surface, as well as systemic inflammatory diseases, significantly increase the risk of developing ectropion.
  • #28 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #29 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    This study investigated potential associations between ectropion and various chronic and systemic inflammatory diseases affecting the eyelids and ocular surface. […] Significant associations were found between involutional ectropion and several local inflammatory eyelid diseases: blepharitis (OR 4.66), chalazion (OR 2.94), hordeolum (OR 2.26), and dermatitis of the eyelid (OR 2.46). […] Ocular surface diseases associated with ectropion included chronic conjunctivitis (OR2.89) and pterygium (OR 2.48). […] Systemic diseases such as hypertension (OR 1.46), dyslipidemia (OR 1.45), and autoimmune rheumatic diseases (OR 1.43) were also associated with involutional ectropion. […] This study found that localized chronic inflammatory conditions affecting the periocular tissues and ocular surface are significantly associated with the development of involutional ectropion.
  • #30 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    This study investigated potential associations between ectropion and various chronic and systemic inflammatory diseases affecting the eyelids and ocular surface. […] Significant associations were found between involutional ectropion and several local inflammatory eyelid diseases: blepharitis (OR 4.66), chalazion (OR 2.94), hordeolum (OR 2.26), and dermatitis of the eyelid (OR 2.46). […] Ocular surface diseases associated with ectropion included chronic conjunctivitis (OR2.89) and pterygium (OR 2.48). […] Systemic diseases such as hypertension (OR 1.46), dyslipidemia (OR 1.45), and autoimmune rheumatic diseases (OR 1.43) were also associated with involutional ectropion. […] This study found that localized chronic inflammatory conditions affecting the periocular tissues and ocular surface are significantly associated with the development of involutional ectropion.
  • #31 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #32 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    This study investigated potential associations between ectropion and various chronic and systemic inflammatory diseases affecting the eyelids and ocular surface. […] Significant associations were found between involutional ectropion and several local inflammatory eyelid diseases: blepharitis (OR 4.66), chalazion (OR 2.94), hordeolum (OR 2.26), and dermatitis of the eyelid (OR 2.46). […] Ocular surface diseases associated with ectropion included chronic conjunctivitis (OR2.89) and pterygium (OR 2.48). […] Systemic diseases such as hypertension (OR 1.46), dyslipidemia (OR 1.45), and autoimmune rheumatic diseases (OR 1.43) were also associated with involutional ectropion. […] This study found that localized chronic inflammatory conditions affecting the periocular tissues and ocular surface are significantly associated with the development of involutional ectropion.
  • #33 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #34 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    This study investigated potential associations between ectropion and various chronic and systemic inflammatory diseases affecting the eyelids and ocular surface. […] Significant associations were found between involutional ectropion and several local inflammatory eyelid diseases: blepharitis (OR 4.66), chalazion (OR 2.94), hordeolum (OR 2.26), and dermatitis of the eyelid (OR 2.46). […] Ocular surface diseases associated with ectropion included chronic conjunctivitis (OR2.89) and pterygium (OR 2.48). […] Systemic diseases such as hypertension (OR 1.46), dyslipidemia (OR 1.45), and autoimmune rheumatic diseases (OR 1.43) were also associated with involutional ectropion. […] This study found that localized chronic inflammatory conditions affecting the periocular tissues and ocular surface are significantly associated with the development of involutional ectropion.
  • #35 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #36 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    We found a strong association between periocular and ocular surface inflammatory diseases and involutional ectropion. […] Chronic conjunctivitis and pterygium were identified as risk factors for the development of ectropion, with chronic conjunctivitis increasing the risk by 2.4 times compared to control group M1 and by 2.9 times compared to control group M2. […] The present study identified statistically significant associations between involutional ectropion and both hypertension and dyslipidemia, suggesting that these cardiovascular risk factors may contribute to the development of paralytic ectropion. […] Additionally, we report statistically significant associations between ectropion and autoimmune rheumatic diseases, the precise mechanisms connecting inflammatory systemic diseases to ocular ectropion remain unclear. […] This study provides compelling evidence that various inflammatory conditions affecting the eyelids and the ocular surface, as well as systemic inflammatory diseases, significantly increase the risk of developing ectropion.
  • #37 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #38 The relationship between involutional ectropion and inflammatory disorders of the eyelids and ocular surface: insights from a large-scale national study | Scientific Reports
    https://www.nature.com/articles/s41598-025-88138-6
    This study investigated potential associations between ectropion and various chronic and systemic inflammatory diseases affecting the eyelids and ocular surface. […] Significant associations were found between involutional ectropion and several local inflammatory eyelid diseases: blepharitis (OR 4.66), chalazion (OR 2.94), hordeolum (OR 2.26), and dermatitis of the eyelid (OR 2.46). […] Ocular surface diseases associated with ectropion included chronic conjunctivitis (OR2.89) and pterygium (OR 2.48). […] Systemic diseases such as hypertension (OR 1.46), dyslipidemia (OR 1.45), and autoimmune rheumatic diseases (OR 1.43) were also associated with involutional ectropion. […] This study found that localized chronic inflammatory conditions affecting the periocular tissues and ocular surface are significantly associated with the development of involutional ectropion.
  • #39 Various Chronic Inflammatory Conditions Linked to Involutional Ectropion
    https://www.reviewofoptometry.com/news/article/various-chronic-inflammatory-conditions-linked-to-involutional-ectropion
    Patients with any of the following inflammatory conditions are at greater risk of developing involutional ectropion, according to a recent study: blepharitis, chalazion, hordeolum, dermatitis of the eyelid, chronic conjunctivitis, pterygium, dyslipidemia or rheumatic disease. […] A relatively common, often age-related condition affecting 2% to 3% of the elderly population is involutional ectropion, characterized by an outward malposition of the eyelid margin due to tarsal laxity and atrophy of the orbicularis muscle and medial and lateral canthal tendons. […] The analysis revealed significant associations between involutional ectropion and several inflammatory diseases, including blepharitis (odds ratio, OR: 4.25), chalazion (OR: 3.01), hordeolum (OR: 2.27), dermatitis of the eyelid (OR: 1.69), chronic conjunctivitis (OR: 3.49), pterygium (OR: 2.21), hypertension (OR: 1.5), dyslipidemia (OR: 1.46) and rheumatic disease (OR: 1.9). All were found to be independent risk factors.
  • #40 Cell-mediated immunity in the course of cervical ectropion
    https://www.imrpress.com/journal/CEOG/21/2/pii/1994021
    In the present study we evaluated cellular immunitary response in course of asymptomatic ectropion. […] Our preliminary findings showed a reduction of CD4, CD8 and CD1 lymphocytic subpopulations in ectropion zones, while these subpopulations are normally present in healthy zones of the exocervix. […] These findings support the hypothesis that, in ectropion, as in HPV infections and in CIN, a localized immuno-deficiency may appear and depress immuno-surveillance and cell-mediated response. […] In conclusion, it may be supposed that ectropion represents a non-stable lesion, which therefore needs suitable therapeutic intervention.
  • #41 Cell-mediated immunity in the course of cervical ectropion
    https://www.imrpress.com/journal/CEOG/21/2/pii/1994021
    In the present study we evaluated cellular immunitary response in course of asymptomatic ectropion. […] Our preliminary findings showed a reduction of CD4, CD8 and CD1 lymphocytic subpopulations in ectropion zones, while these subpopulations are normally present in healthy zones of the exocervix. […] These findings support the hypothesis that, in ectropion, as in HPV infections and in CIN, a localized immuno-deficiency may appear and depress immuno-surveillance and cell-mediated response. […] In conclusion, it may be supposed that ectropion represents a non-stable lesion, which therefore needs suitable therapeutic intervention.
  • #42 Cell-mediated immunity in the course of cervical ectropion
    https://www.imrpress.com/journal/CEOG/21/2/pii/1994021
    In the present study we evaluated cellular immunitary response in course of asymptomatic ectropion. […] Our preliminary findings showed a reduction of CD4, CD8 and CD1 lymphocytic subpopulations in ectropion zones, while these subpopulations are normally present in healthy zones of the exocervix. […] These findings support the hypothesis that, in ectropion, as in HPV infections and in CIN, a localized immuno-deficiency may appear and depress immuno-surveillance and cell-mediated response. […] In conclusion, it may be supposed that ectropion represents a non-stable lesion, which therefore needs suitable therapeutic intervention.
  • #43 Ectropion in Dermatologic Surgery: Exploration and Reconstruction Techniques | Actas Dermo-Sifiliográficas
    https://actasdermo.org/en-ectropion-in-dermatologic-surgery-exploration-articulo-S1578219020300251
    Appropriate eyelid examination should be conducted prior to all types of periocular surgery. This will determine the risk of postoperative ectropion and enable compensatory elements to be included when planning the operation. When ectropion is already present, examination will serve to determine the predominant pathogenic component and enable the most appropriate repair technique to be chosen. […] Knowledge of basic eyelid anatomy and adequate preoperative examination will enable the dermatologic surgeon to design the most effective surgical procedures to avoid ectropion, or, if applicable, choose the best type of repair surgery according to the predominant causal component.
  • #44 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #45 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #46 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #47 A Clinical Guide to Ectropion
    https://eyesoneyecare.com/resources/clinical-guide-to-ectropion/
    The prevalence of ectropion is the same between genders but presents at a higher rate in men aged 80 and older. Factors that lead to ectropion development include a history of systemic hypertension, diabetes, tobacco use, and stroke. The risk of ectropion development is increased when there is a history of skin cancer and sun sensitivity. […] Physical and slit lamp examination can be used to efficiently assess ectropion appearance and its’ potential progression. Assessment of risk factors and co-morbid conditions remains valuable in reducing the incidence of ectropion progression. Early detection can play a role in the conservative management of ectropion, which often leads to improved outcomes. For long-term management and in cases of severe ectropion, surgical intervention remains the definitive treatment.
  • #48 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion
    https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en
    The incidence of cicatricial ectropion in these patients varies between 45 to 80%. […] Cicatricial ectropion may appear as a consequence of a long-term misdiagnosis of DLE in the presence of chronic eyelid lesions and may require surgical repair. […] Cicatricial ectropion may occur after excising lesions followed by primary closure or more complex eyelid reconstruction. Its incidence following tumor excision of the lower eyelid has been reported to vary between 2.5 to 7%, and 14.2% after a full-thickness skin graft. […] Larger diameter wounds, especially those greater than 21 mm, were more likely to result in ectropion. […] Other factors contributing to ectropion development include graft contraction and infection. […] The ectropion is reported to be noticeable about one to two months after the procedure. […] Correcting horizontal eyelid laxity during entropion treatment and more conservative surgeries may be advisable to avoid such complications.
  • #49 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion
    https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en
    The incidence of cicatricial ectropion in these patients varies between 45 to 80%. […] Cicatricial ectropion may appear as a consequence of a long-term misdiagnosis of DLE in the presence of chronic eyelid lesions and may require surgical repair. […] Cicatricial ectropion may occur after excising lesions followed by primary closure or more complex eyelid reconstruction. Its incidence following tumor excision of the lower eyelid has been reported to vary between 2.5 to 7%, and 14.2% after a full-thickness skin graft. […] Larger diameter wounds, especially those greater than 21 mm, were more likely to result in ectropion. […] Other factors contributing to ectropion development include graft contraction and infection. […] The ectropion is reported to be noticeable about one to two months after the procedure. […] Correcting horizontal eyelid laxity during entropion treatment and more conservative surgeries may be advisable to avoid such complications.
  • #50 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion
    https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en
    The incidence of cicatricial ectropion in these patients varies between 45 to 80%. […] Cicatricial ectropion may appear as a consequence of a long-term misdiagnosis of DLE in the presence of chronic eyelid lesions and may require surgical repair. […] Cicatricial ectropion may occur after excising lesions followed by primary closure or more complex eyelid reconstruction. Its incidence following tumor excision of the lower eyelid has been reported to vary between 2.5 to 7%, and 14.2% after a full-thickness skin graft. […] Larger diameter wounds, especially those greater than 21 mm, were more likely to result in ectropion. […] Other factors contributing to ectropion development include graft contraction and infection. […] The ectropion is reported to be noticeable about one to two months after the procedure. […] Correcting horizontal eyelid laxity during entropion treatment and more conservative surgeries may be advisable to avoid such complications.
  • #51 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion
    https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en
    The incidence of cicatricial ectropion in these patients varies between 45 to 80%. […] Cicatricial ectropion may appear as a consequence of a long-term misdiagnosis of DLE in the presence of chronic eyelid lesions and may require surgical repair. […] Cicatricial ectropion may occur after excising lesions followed by primary closure or more complex eyelid reconstruction. Its incidence following tumor excision of the lower eyelid has been reported to vary between 2.5 to 7%, and 14.2% after a full-thickness skin graft. […] Larger diameter wounds, especially those greater than 21 mm, were more likely to result in ectropion. […] Other factors contributing to ectropion development include graft contraction and infection. […] The ectropion is reported to be noticeable about one to two months after the procedure. […] Correcting horizontal eyelid laxity during entropion treatment and more conservative surgeries may be advisable to avoid such complications.
  • #52 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion
    https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en
    The incidence of cicatricial ectropion in these patients varies between 45 to 80%. […] Cicatricial ectropion may appear as a consequence of a long-term misdiagnosis of DLE in the presence of chronic eyelid lesions and may require surgical repair. […] Cicatricial ectropion may occur after excising lesions followed by primary closure or more complex eyelid reconstruction. Its incidence following tumor excision of the lower eyelid has been reported to vary between 2.5 to 7%, and 14.2% after a full-thickness skin graft. […] Larger diameter wounds, especially those greater than 21 mm, were more likely to result in ectropion. […] Other factors contributing to ectropion development include graft contraction and infection. […] The ectropion is reported to be noticeable about one to two months after the procedure. […] Correcting horizontal eyelid laxity during entropion treatment and more conservative surgeries may be advisable to avoid such complications.
  • #53 SciELO Brazil – Diseases, conditions, and drugs associated with cicatricial ectropion Diseases, conditions, and drugs associated with cicatricial ectropion
    https://www.scielo.br/j/abo/a/btVBjDfZDTLjTPQXWDffb4F/?lang=en
    The incidence of cicatricial ectropion in these patients varies between 45 to 80%. […] Cicatricial ectropion may appear as a consequence of a long-term misdiagnosis of DLE in the presence of chronic eyelid lesions and may require surgical repair. […] Cicatricial ectropion may occur after excising lesions followed by primary closure or more complex eyelid reconstruction. Its incidence following tumor excision of the lower eyelid has been reported to vary between 2.5 to 7%, and 14.2% after a full-thickness skin graft. […] Larger diameter wounds, especially those greater than 21 mm, were more likely to result in ectropion. […] Other factors contributing to ectropion development include graft contraction and infection. […] The ectropion is reported to be noticeable about one to two months after the procedure. […] Correcting horizontal eyelid laxity during entropion treatment and more conservative surgeries may be advisable to avoid such complications.
  • #54 Cervical Ectropion | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19233
    Cervical ectropion is one of the most commonly found gynecological conditions. The prevalence of cervical ectropion ranges between 17 percent and 50 percent. The prevalence increases with parity but decreases with age 35 and above. Cervical ectropion can be found in up to 80% of sexually active adolescents. The prevalence also depends on the type of contraception used. It is seen more commonly in women taking oral contraceptive pills and less so in women using barrier methods of contraception. […] Studies show that 54.9 percent of women in Benghazi, Libya, that use oral contraceptive pills and intra-uterine copper devices have cervical ectropion. Thus it was the most prevalent gynecological disorder in that population. 43.2 percent of women in China were reported as having cervical ectropion. […] The prevalence of cervical ectropion is about 29 percent in premature female infants and 68 percent in the first month of life due to the transfer of maternal estrogen through the placenta.
  • #55 Cervical Ectropion | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19233
    Cervical ectropion is one of the most commonly found gynecological conditions. The prevalence of cervical ectropion ranges between 17 percent and 50 percent. The prevalence increases with parity but decreases with age 35 and above. Cervical ectropion can be found in up to 80% of sexually active adolescents. The prevalence also depends on the type of contraception used. It is seen more commonly in women taking oral contraceptive pills and less so in women using barrier methods of contraception. […] Studies show that 54.9 percent of women in Benghazi, Libya, that use oral contraceptive pills and intra-uterine copper devices have cervical ectropion. Thus it was the most prevalent gynecological disorder in that population. 43.2 percent of women in China were reported as having cervical ectropion. […] The prevalence of cervical ectropion is about 29 percent in premature female infants and 68 percent in the first month of life due to the transfer of maternal estrogen through the placenta.
  • #56 Cervical Ectropion | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19233
    Cervical ectropion is one of the most commonly found gynecological conditions. The prevalence of cervical ectropion ranges between 17 percent and 50 percent. The prevalence increases with parity but decreases with age 35 and above. Cervical ectropion can be found in up to 80% of sexually active adolescents. The prevalence also depends on the type of contraception used. It is seen more commonly in women taking oral contraceptive pills and less so in women using barrier methods of contraception. […] Studies show that 54.9 percent of women in Benghazi, Libya, that use oral contraceptive pills and intra-uterine copper devices have cervical ectropion. Thus it was the most prevalent gynecological disorder in that population. 43.2 percent of women in China were reported as having cervical ectropion. […] The prevalence of cervical ectropion is about 29 percent in premature female infants and 68 percent in the first month of life due to the transfer of maternal estrogen through the placenta.
  • #57 Cervical Ectropion | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19233
    Cervical ectropion is one of the most commonly found gynecological conditions. The prevalence of cervical ectropion ranges between 17 percent and 50 percent. The prevalence increases with parity but decreases with age 35 and above. Cervical ectropion can be found in up to 80% of sexually active adolescents. The prevalence also depends on the type of contraception used. It is seen more commonly in women taking oral contraceptive pills and less so in women using barrier methods of contraception. […] Studies show that 54.9 percent of women in Benghazi, Libya, that use oral contraceptive pills and intra-uterine copper devices have cervical ectropion. Thus it was the most prevalent gynecological disorder in that population. 43.2 percent of women in China were reported as having cervical ectropion. […] The prevalence of cervical ectropion is about 29 percent in premature female infants and 68 percent in the first month of life due to the transfer of maternal estrogen through the placenta.
  • #58 Cervicitis, Ectropion, and True Erosion | 5-Minute Clinical Consult
    https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116119/all/Cervicitis_Ectropion_and_True_Erosion?q=CONTRACEPTIVES%2C+HORMONAL
    Ectropion is the eversion of the endocervix, exposing the columnar cells to the vaginal environment. This is more common in adolescents and pregnancy and can be confused for cervicitis. […] Ectropion: typically related to higher levels of estrogen; ectropion is common among adolescents, women using combined oral contraceptive pills (OCPs), and pregnant women. […] Ectropion: adolescence, pregnancy, use of OCP.
  • #59 Cervical Ectropion | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19233
    Cervical ectropion is one of the most commonly found gynecological conditions. The prevalence of cervical ectropion ranges between 17 percent and 50 percent. The prevalence increases with parity but decreases with age 35 and above. Cervical ectropion can be found in up to 80% of sexually active adolescents. The prevalence also depends on the type of contraception used. It is seen more commonly in women taking oral contraceptive pills and less so in women using barrier methods of contraception. […] Studies show that 54.9 percent of women in Benghazi, Libya, that use oral contraceptive pills and intra-uterine copper devices have cervical ectropion. Thus it was the most prevalent gynecological disorder in that population. 43.2 percent of women in China were reported as having cervical ectropion. […] The prevalence of cervical ectropion is about 29 percent in premature female infants and 68 percent in the first month of life due to the transfer of maternal estrogen through the placenta.
  • #60 Cervical Ectropion | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19233
    Cervical ectropion is one of the most commonly found gynecological conditions. The prevalence of cervical ectropion ranges between 17 percent and 50 percent. The prevalence increases with parity but decreases with age 35 and above. Cervical ectropion can be found in up to 80% of sexually active adolescents. The prevalence also depends on the type of contraception used. It is seen more commonly in women taking oral contraceptive pills and less so in women using barrier methods of contraception. […] Studies show that 54.9 percent of women in Benghazi, Libya, that use oral contraceptive pills and intra-uterine copper devices have cervical ectropion. Thus it was the most prevalent gynecological disorder in that population. 43.2 percent of women in China were reported as having cervical ectropion. […] The prevalence of cervical ectropion is about 29 percent in premature female infants and 68 percent in the first month of life due to the transfer of maternal estrogen through the placenta.
  • #61 Cervical Ectropion | Treatment & Management | Point of Care
    https://www.statpearls.com/point-of-care/19233
    Cervical ectropion is one of the most commonly found gynecological conditions. The prevalence of cervical ectropion ranges between 17 percent and 50 percent. The prevalence increases with parity but decreases with age 35 and above. Cervical ectropion can be found in up to 80% of sexually active adolescents. The prevalence also depends on the type of contraception used. It is seen more commonly in women taking oral contraceptive pills and less so in women using barrier methods of contraception. […] Studies show that 54.9 percent of women in Benghazi, Libya, that use oral contraceptive pills and intra-uterine copper devices have cervical ectropion. Thus it was the most prevalent gynecological disorder in that population. 43.2 percent of women in China were reported as having cervical ectropion. […] The prevalence of cervical ectropion is about 29 percent in premature female infants and 68 percent in the first month of life due to the transfer of maternal estrogen through the placenta.
  • #62 Acquired Ectropion Uveae – EyeWiki
    https://eyewiki.org/Acquired_Ectropion_Uveae
    Acquired ectropion uveae is much more frequently encountered than its congenital counterpart, and the prevalence of AEU varies according to the underlying cause: […] It is most commonly encountered during the angle-closure stage of neovascular glaucoma and absolute glaucoma (uncontrolled rise of IOP) patients. […] In iris melanoma, a retrospective study conducted over a 40-year span by Shields et al. identified ectropion uveae in 24 out of 317 patients (7.6%). […] Its prevalence is even higher in cases of diffuse iris melanoma, with one study finding 21 out of 25 patients (84%) manifesting concurrent ectropion uveae. […] Central retinal vein occlusion (CRVO) is another common cause for AEU, with as many as 60% of ischemic CRVO cases being associated with NVI and AEU. […] Finally, ICE syndrome frequently leads to AEU. A retrospective analysis including 144 cases of ICE syndrome found that approximately one-fourth (24.6%) of these patients develop AEU, particularly prevalent in Cogan-Reese syndrome (54.2%, 13 out of 24 cases).
  • #63 Acquired Ectropion Uveae – EyeWiki
    https://eyewiki.org/Acquired_Ectropion_Uveae
    Acquired ectropion uveae is much more frequently encountered than its congenital counterpart, and the prevalence of AEU varies according to the underlying cause: […] It is most commonly encountered during the angle-closure stage of neovascular glaucoma and absolute glaucoma (uncontrolled rise of IOP) patients. […] In iris melanoma, a retrospective study conducted over a 40-year span by Shields et al. identified ectropion uveae in 24 out of 317 patients (7.6%). […] Its prevalence is even higher in cases of diffuse iris melanoma, with one study finding 21 out of 25 patients (84%) manifesting concurrent ectropion uveae. […] Central retinal vein occlusion (CRVO) is another common cause for AEU, with as many as 60% of ischemic CRVO cases being associated with NVI and AEU. […] Finally, ICE syndrome frequently leads to AEU. A retrospective analysis including 144 cases of ICE syndrome found that approximately one-fourth (24.6%) of these patients develop AEU, particularly prevalent in Cogan-Reese syndrome (54.2%, 13 out of 24 cases).
  • #64 Acquired Ectropion Uveae – EyeWiki
    https://eyewiki.org/Acquired_Ectropion_Uveae
    Acquired ectropion uveae is much more frequently encountered than its congenital counterpart, and the prevalence of AEU varies according to the underlying cause: […] It is most commonly encountered during the angle-closure stage of neovascular glaucoma and absolute glaucoma (uncontrolled rise of IOP) patients. […] In iris melanoma, a retrospective study conducted over a 40-year span by Shields et al. identified ectropion uveae in 24 out of 317 patients (7.6%). […] Its prevalence is even higher in cases of diffuse iris melanoma, with one study finding 21 out of 25 patients (84%) manifesting concurrent ectropion uveae. […] Central retinal vein occlusion (CRVO) is another common cause for AEU, with as many as 60% of ischemic CRVO cases being associated with NVI and AEU. […] Finally, ICE syndrome frequently leads to AEU. A retrospective analysis including 144 cases of ICE syndrome found that approximately one-fourth (24.6%) of these patients develop AEU, particularly prevalent in Cogan-Reese syndrome (54.2%, 13 out of 24 cases).
  • #65 Acquired Ectropion Uveae – EyeWiki
    https://eyewiki.org/Acquired_Ectropion_Uveae
    Acquired ectropion uveae is much more frequently encountered than its congenital counterpart, and the prevalence of AEU varies according to the underlying cause: […] It is most commonly encountered during the angle-closure stage of neovascular glaucoma and absolute glaucoma (uncontrolled rise of IOP) patients. […] In iris melanoma, a retrospective study conducted over a 40-year span by Shields et al. identified ectropion uveae in 24 out of 317 patients (7.6%). […] Its prevalence is even higher in cases of diffuse iris melanoma, with one study finding 21 out of 25 patients (84%) manifesting concurrent ectropion uveae. […] Central retinal vein occlusion (CRVO) is another common cause for AEU, with as many as 60% of ischemic CRVO cases being associated with NVI and AEU. […] Finally, ICE syndrome frequently leads to AEU. A retrospective analysis including 144 cases of ICE syndrome found that approximately one-fourth (24.6%) of these patients develop AEU, particularly prevalent in Cogan-Reese syndrome (54.2%, 13 out of 24 cases).
  • #66 Acquired Ectropion Uveae – EyeWiki
    https://eyewiki.org/Acquired_Ectropion_Uveae
    Acquired ectropion uveae is much more frequently encountered than its congenital counterpart, and the prevalence of AEU varies according to the underlying cause: […] It is most commonly encountered during the angle-closure stage of neovascular glaucoma and absolute glaucoma (uncontrolled rise of IOP) patients. […] In iris melanoma, a retrospective study conducted over a 40-year span by Shields et al. identified ectropion uveae in 24 out of 317 patients (7.6%). […] Its prevalence is even higher in cases of diffuse iris melanoma, with one study finding 21 out of 25 patients (84%) manifesting concurrent ectropion uveae. […] Central retinal vein occlusion (CRVO) is another common cause for AEU, with as many as 60% of ischemic CRVO cases being associated with NVI and AEU. […] Finally, ICE syndrome frequently leads to AEU. A retrospective analysis including 144 cases of ICE syndrome found that approximately one-fourth (24.6%) of these patients develop AEU, particularly prevalent in Cogan-Reese syndrome (54.2%, 13 out of 24 cases).
  • #67 Acquired Ectropion Uveae – EyeWiki
    https://eyewiki.org/Acquired_Ectropion_Uveae
    Acquired ectropion uveae is much more frequently encountered than its congenital counterpart, and the prevalence of AEU varies according to the underlying cause: […] It is most commonly encountered during the angle-closure stage of neovascular glaucoma and absolute glaucoma (uncontrolled rise of IOP) patients. […] In iris melanoma, a retrospective study conducted over a 40-year span by Shields et al. identified ectropion uveae in 24 out of 317 patients (7.6%). […] Its prevalence is even higher in cases of diffuse iris melanoma, with one study finding 21 out of 25 patients (84%) manifesting concurrent ectropion uveae. […] Central retinal vein occlusion (CRVO) is another common cause for AEU, with as many as 60% of ischemic CRVO cases being associated with NVI and AEU. […] Finally, ICE syndrome frequently leads to AEU. A retrospective analysis including 144 cases of ICE syndrome found that approximately one-fourth (24.6%) of these patients develop AEU, particularly prevalent in Cogan-Reese syndrome (54.2%, 13 out of 24 cases).
  • #68
    https://www.msjonline.org/index.php/ijrms/article/view/1740
    Ichthyosiform dermatoses are a group of hereditary disorders characterized by dryness and roughness of the skin with excessive accumulation of epidermal scales. […] Lamellar ichthyosis is the rarest form with an incidence of 1 in 3, 00,000. […] Ocular manifestations include exposure keratitis secondary to ectropion, unilateral megalocornea, and enlarged corneal nerve, and blepharitis, absence of the meibomian gland, trichiasis, madarosis and absence of lacrimal puncta. […] Ectropion of both upper and lower lids have been documented.
  • #69
    https://www.msjonline.org/index.php/ijrms/article/view/1740
    Ichthyosiform dermatoses are a group of hereditary disorders characterized by dryness and roughness of the skin with excessive accumulation of epidermal scales. […] Lamellar ichthyosis is the rarest form with an incidence of 1 in 3, 00,000. […] Ocular manifestations include exposure keratitis secondary to ectropion, unilateral megalocornea, and enlarged corneal nerve, and blepharitis, absence of the meibomian gland, trichiasis, madarosis and absence of lacrimal puncta. […] Ectropion of both upper and lower lids have been documented.
  • #70
    https://www.msjonline.org/index.php/ijrms/article/view/1740
    Ichthyosiform dermatoses are a group of hereditary disorders characterized by dryness and roughness of the skin with excessive accumulation of epidermal scales. […] Lamellar ichthyosis is the rarest form with an incidence of 1 in 3, 00,000. […] Ocular manifestations include exposure keratitis secondary to ectropion, unilateral megalocornea, and enlarged corneal nerve, and blepharitis, absence of the meibomian gland, trichiasis, madarosis and absence of lacrimal puncta. […] Ectropion of both upper and lower lids have been documented.
  • #71
    https://www.msjonline.org/index.php/ijrms/article/view/1740
    Ichthyosiform dermatoses are a group of hereditary disorders characterized by dryness and roughness of the skin with excessive accumulation of epidermal scales. […] Lamellar ichthyosis is the rarest form with an incidence of 1 in 3, 00,000. […] Ocular manifestations include exposure keratitis secondary to ectropion, unilateral megalocornea, and enlarged corneal nerve, and blepharitis, absence of the meibomian gland, trichiasis, madarosis and absence of lacrimal puncta. […] Ectropion of both upper and lower lids have been documented.