Drug Induced Ectropion: a Systematic Review

Background: To review etiologies, risk factors, management and prognosis of drug induced ectropion as a rare entity. Material and Methods: In this systematic review, we reviewed all related published articles in English literature until April 2019 by searching Pubmed resources using the keywords ‘drug induced ectropion’. Results: We found 26 relevant articles describing 48 patients with drug induced ectropion. The patient mean age was 67.4 years (range 15-93 years). Different topical and systemic drugs were reported as the causing agents including chemotherapeutic (45.8 %) drugs as the most frequent cause (22 patients, including 5 patients using topical fluorouracil, 9 patients using systemic fluorouracil, 7 patients using epidermal growth factor receptor inhibitors, and 1 patient using docetaxel), followed by topical anti-glaucoma (39.5 %) drugs (19 patients). The mean interval between starting the drug usage and emergence of ectropion was 9.74 months (range 1 day-72 months). Cessation of the causing drug and conservative treatments including topical lubricants, antibiotics and steroids were the most common management method. Surgery was required only in 10 patients (20.8 %). Conclusion: Drug induced ectropion can develop following the administration of various topical and systemic drugs. Discontinuation of the causing drug and conservative treatments including topical steroids are often successful in managing the ectropion. Surgical treatment is scarcely needed among patients with drug induced ectropion.