The Association Between Blepharitis and Lower Eyelid Ectropion in a Large Cohort of Patients.

Purpose: Blepharitis and lower eyelid ectropion are highly prevalent ocular conditions occurring in 37%-46% and 2-3% of the general adult population, respectively. Blepharitis has multifactorial origins and involves anterior and posterior types of eyelid inflammation. Lower eyelid ectropion results in ocular surface exposure, epiphora and chronic conjunctivitis. This study aims to investigate any possible association between both conditions.

Methods: Medical records of 37,692 consecutive patients examined at a single medical screening center between 2001-2020 were retrospectively analyzed.

Main outcome measures: The prevalence of lower eyelid ectropion and of blepharitis, a possible association between the two, and the relation of each to age and sex.

Results: A total of 35,670 patients were included. Ectropion was diagnosed in 69 patients (0.2%), and blepharitis in 4725 patients (13.2%). Male sex was more prevalent for each pathology (88.4% ectropion, and 85% blepharitis, p < .001). Older age was associated with each diagnosis (77.3 years for ectropion patients vs. 52.2 years for the general screened population and 60.5 years for blepharitis patients vs 52.2 years for the general screened population p < .001). The prevalence of ectropion was significantly higher in patients with coexisting blepharitis compared to those without (0.8% vs. 0.1%, respectively, p < .001).

Conclusions: Ectropion was significantly more prevalent in patients with blepharitis. Both conditions were associated with older age and male sex. This coexistence can aid in decision making of early surgical intervention of lower eyelid ectropion as well as the approach to medical treatment of blepharitis.