Entropion in Dogs

Entropion is a condition whereby an animal has eyelids that roll inward excessively. This causes its eyelashes and eyelid skin to brush against its eye, leading to irritation. When this condition has been going on for long periods of time, the constant rubbing on the surface of the eye causes the eye to toughen up and actually become a layer of skin. New blood vessels help to maintain this new layer of skin, and the surface can start to form a dark pigment. These are all protective mechanisms, to ensure the eye can withstand the constant rubbing. Not surprisingly, entropion can eventually lead to corneal ulcers as well, due to the constant irritation. All in all, this can eventually lead to loss of vision in the affected eye(s).

Many breeds (like Great Danes, Chows and Bulldogs) have a tendency for entropion, but the poster child is the Shar-Pei; who often have entropion on both eyes and on both upper and lower lids. Some dogs manage to live with this better than others, and dogs can present with a wide variety of symptoms. Some seem to cope easily, while others are squinting, tearing excessively, have corneal ulcers and are definitely in a lot of pain.

Entropion is often hereditary (especially in certain breeds) and thus dogs with entropion should not be bred. Entropion can also be acquired. It is important to differentiate an entropion from an animal with an apparent entropion due to their eyes being slightly smaller than usual!
An entropion is diagnosed after a series of tests are done. For example, your vet will measure your dog’s ability to produce tears and will also test its reflexes to see whether its optic nerve is working properly and also apply a fluoroscein dye to look for evidence of corneal ulcers or scarring. They will also measure the pressure inside your dog’s eye to ensure that other diseases aren’t occurring as well.

The treatment for entropion depends on the severity of the defect, as well as how well the animal is coping. Regularly applying a tear gel or other eye lubricant can help greatly, as it keeps everything moist and smooth, and coats the hairs touching the eye so that they do less damage. However, if the animal is showing signs of discomfort and the entropion is severe, a few options are available. For breeds with a heavy brow, such as Shar-Peis and Bloodhounds, a ‘brow lift’ or even a ‘face lift’ may be done. To do this, a small crescent of skin is removed over each brow, and then the remaining skin is pulled together and up. This procedure is only done on dogs with severe entropion, because it is fairly invasive and infection is a major complication.

With most dogs with entropion, a procedure called a Hotz-Celsus is done. In this surgery, a small crescent of skin is removed from the bottom eyelid, and the remaining tissue is sutured together. This pulls the eyelid outward, which most often corrects the defect. However, keep in mind that eyelid surgery is delicate, and your vet would rather under-correct and have to do a second surgery rather than over-correct. If too much skin is removed, the animal could end up with ectropion; the opposite problem whereby the lid rolls outward!

The prognosis for animals with entropion is fairly good. A minor entropion can often be corrected completely with one surgery, whereas a severe one may take several attempts. Often tear drops need to be used 3 to 4 times per day for life. However, with some dedication and effort on your part, dogs with entropion usually live long and healthy lives despite their condition.