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Step 1
Gather the patient's history. Patients with ectropion may have this condition for years before seeking medical attention. The most frequent presenting symptoms are irritated and red eyes with frequent tearing. Constant wiping of the eyes and long-term use of eye drops also is common.
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Step 2
Conduct a physical examination, especially of the face. Ectropion may be the result of floppy eyelid syndrome, cancerous skin conditions, prior surgical scars or burns. The cornea and conjunctiva may show signs of ulceration and keratinization.
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Step 3
Perform simple tests on the eyelids to check for excessive laxity of the lids. An anterior lid distraction greater than 8 mm indicates abnormal laxity as does a slow return of the eyelid to its normal position after pulling it inferiorly.
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Step 4
Displace the lower lid margin to check for cicatricial ectropion. An extension of the lower lid margin less than 2mm above the inferior limbus may indicate cicatricial ectropion.
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Step 5
Measure the extent of paralytic ectropion. Document any disparity between voluntary and spontaneous lid closure. Observe any inability to close the eyelids completely by having the patient gently close the eyelids while in a supine position. Test for the presence of Bell phenomenon and document any sensations on the cornea.
