Objective: This report describes a clinically rare case of congenital
ectropion involving both upper lids in a one-day-old Indian newborn. We emphasize the importance of non-invasive
conservative management with 5% hypertonic saline. Method: Observational case report Result: A term newborn presented to us on day 1 with bilateral upper lid
ectropion or 'double congenital
ectropion' noted since birth following an uneventful vaginal delivery. Examination revealed severe chemosis and
prolapse of upper palpebral conjunctiva bilaterally. The repeated attempts to manually revert the eyelids in position failed. Otherwise, the eyes were normal. We started to treat the baby with topical hypertonic saline (5%
sodium chloride), topical
antibiotic, and topical
lubricant frequently. Eye pads soaked in 5% hypertonic saline were also used. Following five days of treatment, the chemosis and
ectropion resolved completely without recurrence. Conclusion: We advocate non-invasive
conservative management with 5% hypertonic saline soaked pads over the eyes along with topical
antibiotic and
lubricants. It should be the first line of treatment in all cases of congenital
ectropion, before jumping to any aggressive invasive treatment like tarsorrhaphy,
skin grafting etc., or unnecessary referral.