Ectropion, or outward turning of the eyelids and lashes, can also occur in the aging eye, as seen in the lower lid of this patient. Ectropion is usually due to involutional changes, although scarring and laxity from loss of innervations due to cranial palsies can also cause this condition. Patients with this condition often complain about epiphora, or tears that run down onto the cheeks. Exposure and secondary drying of the cornea, with consequent corneal epithelial loss, can also occur. The eye should be protected with lubricant if the eyelid does not completely close. The treatment is surgical. Again, patients should be referred to an ophthalmologist if they are symptomatic.