Congenital ectropion of the upper lid is a rare condition that, if treated early, can be managed without recourse to surgery. We report a case in which an initial attempt at treatment with a pressure bandage failed, leading to a rapid worsening of the condition. A subsequent attempt at repositioning led to a respiratory arrest. Successful resolution occurred after taping of the lid. The case illustrates the need for early successful repositioning to break a cycle leading to increasing lid oedema; it also illustrates the importance of vigilance to the autonomic effects of lid manipulations in neonates.