This commonly seen outward turning of the lower eyelid in the elderly is eminently treatable and responds well to minor surgery. Senile ectropion can begin with slight separation of the lower eyelid from the globe, and the malposition of the punctum leads to overflow of tears and conjunctival infection. Irritation of the skin by the tears and rubbing of the eyes lead to skin contracture and further downward pulling of the eyelids. Like entropion, ectropion can be cicatricial and result from scarring of the skin of the eyelids. It can also follow a seventh cranial nerve palsy caused by complete inaction of the orbicularis muscle; this is called paralytic ectropion.
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