Eyelid Problems - Entropion

Entropion is inturning or inversion of the eyelid. It is frequently only the lower lid that is involved although both lids can be affected in Shar Peis and Chow Chows. It is common in many dogs and is inherited in some breeds. 

Cocker Spaniels, Labrador Retrievers, Golden Retrievers and Chow Chows are commonly affected together with other popular breeds. In some, such as the St Bernard and Bloodhound, the looseness of the skin on the head probably plays a part.

A small or deep-set eye can also predispose to the development of inward rolling eyelids as the eye does not provide support for the growing eyelids.

What is the cause of the problem?

The problem can be due to either an excess of eyelid tissue or a small eye, or both. This results in a variable amount of the hair covered eyelid turning inwards with the hairs rubbing directly on the front of the eye (cornea). This is extremely painful and not surprisingly the dog tries to alleviate this by pawing or rubbing at the eye, making the problem worse.

Without treatment the cornea (clear part of the eye) can be so seriously damaged that ulceration and even blindness can result.

When does this first occur?

Affected dogs are usually showing signs by six months of age. In some, such as the Shar Pei, signs can be apparent very soon after the eyes have opened, at approximately two weeks of age, and are certainly well established by one month.

What are the signs?

Initially there is excessive blinking and over-spill of tears so that the dog appears to have a permanently wet face. It may also hold the eye closed.

"Initially there is excessive blinking and over-spill of tears so that the dog appears to have a permanently wet face."

What can be done?

This depends upon the breed and severity. Occasionally the condition is self correcting as the puppy grows. However the majority of affected dogs need specialised surgery. The position of the eyelid has to be corrected surgically so that hairs do not impinge upon the delicate surface of the eye.

Is surgery successful?

In experienced hands surgery is usually very successful. Referral to a veterinary ophthalmologist is often advised.

When can surgery be carried out?

Surgery is required if the dog is in pain, and especially if corneal ulceration has developed. However, if the puppy is still growing, it might require further surgery when older. Sometimes, temporary measures, such as placing everting sutures along the eyelids, are performed in very young puppies. Usually, for permanent cure, it is necessary to wait until growth of the eyelid is complete before surgery is undertaken but it is not acceptable to leave a pet in discomfort and run the risk of further complications by delaying surgery. Each animal will be assessed on an individual basis as to the best time to undertake surgical correction.  

Does surgery alter the appearance of the eye?

The aim is to reduce the irritation and soreness suffered by the dog. As a result successful surgery results in a normal appearance.

Can surgery be avoided?

In some cases application of antibiotics, anti inflammatory agents and other soothing eye preparations or temporary surgery (eye tacking) relieves the problem sufficiently that as a result of growth and development the condition resolves. However, this is usually the exception rather than the rule.