ZyraDoc #32 - September 02, 2026

A 79-year-old man presents with constant, involuntary tear overflow onto his face and progressive redness of his left eye.

Examination reveals that his left lower eyelid margin is sagging completely outward, entirely separated from the surface of the globe.

The exposed palpebral conjunctiva appears significantly hyperaemic, thickened, and severely dehydrated due to atmospheric exposure.

Case Summary

Clinical Focus:

A 79-year-old male presents with advanced involutional ectropion of the left lower eyelid complicated by chronic palpebral conjunctival dehydration and severe secondary epiphora.

Diagnostic criteria for ectropion include:

Eversion or outward turning of the eyelid margin away from the surface of the globe.
Displacement or eversion of the lower lacrimal puncta away from the tear lake, completely blocking functional tear drainage.
Involuntary overflow of tears onto the face (epiphora) driven by an anatomical drainage system breakdown.
Pathophysiology heavily driven by age-related orbicularis oculi muscle laxity, trauma-induced fibrosis, or cranial nerve VII palsy.

When conservative moisture drops fail to manage progressive ocular surface dehydration or tissue thickening, definitive surgical correction is required to restore anatomical lid positioning.

Here is the Management Strategy:

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