As the eyelid rolls inward, the eyelashes and fur on the eyelid touch and rub the eye, causing irritation and corneal abrasion or injuries. If not treated or corrected accordingly, severe entropion cases result in deep corneal injuries with increased risks of vision impairment.
Most cases of entropion in dogs are genetic. Certain breeds of dogs are more predisposed to developing the condition for different reasons. Brachycephalic breeds like Bulldogs, Boxers, and Pugs develop entropion as they get older because the conformation of their muzzle and face leads to excessive tension on the ligaments around the inner corners of their eyes. This excess ligament tension causes the upper and lower eyelid to roll inwards.
The opposite happens in giant breeds like Great Danes, Saint Bernards, and Bullmastiffs. In these breeds, the ligaments around the outer eyes have excess slack which results in the inward rolling of the upper and lower eyelids. This is how sporting breeds like Retrievers and Irish Setters develop entropion as well.
In some breeds like Shar Peis and Cavalier King Charles Spaniel Spaniels, skull formation and excessive skin folds, coupled with prominent, bulging eyes increase the risks of entropion and complications that go with the condition.
Not all cases of entropion are genetic, some are secondary to certain medical conditions. Eyelid scarring and nerve damage from previous injuries, infections around the eyes and eyelids, and excessive weight loss, causing excess skin around the eyes, can also lead to the development of entropion in dogs.
Dogs with entropion do not usually develop obvious symptoms outright, since the development of the condition is not usually abrupt and spontaneous. The inward rolling of the eyelids usually takes some time before it can cause enough irritation and damage to the eye itself and result in symptoms.
Initial signs include general eye discomfort, and dogs with developing entropion will typically have a mild sensitivity to light and may occasionally rub or paw at their face. Excessive eye discharge is typically observed, accompanied by bloodshot eyes. Affected dogs will often exhibit eye squinting and profuse blinking once the irritation and inflammation have become significant.
In giant and sporting breeds, excessive tear production, often mucoid and purulent, can be seen from the outer corner of the eye. If the entropion leads to corneal damage like ulceration and abrasion, the cornea will become cloudy or hazy in appearance. Depending on the severity, the corneal ulcers or abrasions may be very subtle or very pronounced and can be easily seen.
In breeds like Shar Peis and Chow Chows that developed entropion due to excessive facial skin folds, sometimes the inward rolling of the eyelids is so severe that it covers the entire eye and can’t be properly seen even when you try to pry open the eyelids.
No special diagnostic test is needed to determine if a dog is suffering from entropion. A thorough physical and eye exam is often enough for your vet to confirm if a dog has entropion.
Once entropion is confirmed, your vet will then assess how bad the complications from the condition are. One of the first things your vet will check is the presence of corneal ulcerations. This is typically done by applying a fluorescent dye to the cornea of the affected eye. If the cornea has ulcerations or scratches, these lesions will take up the dye and give off a fluorescent glow under blue light, while healthy corneal tissue will remain clear.
Surgical correction is the only permanent way to treat entropion in dogs. The surgical procedure, called blepharoplasty, involves removing tissues from the upper and/or lower eyelid to eliminate the inward rolling of the eyelids. In genetic cases of entropion, the surgery is usually performed when the dog is at least 6 months of age. Doing the surgery too early, especially in breeds with excessive facial skin folds, does not eliminate the risks of entropion, as the pup can still develop additional skin folds and risk entropion development again as the puppy gets older.
Another surgical approach to treat entropion in dogs is by placing temporary sutures around the eyelids to fix them in appropriate places to prevent the inward rolling of the eyelids. This is typically done in puppies showing severe signs of entropion but are not old enough for blepharoplasty procedures yet.
In secondary entropion cases, diagnosing and treating the underlying condition may be enough to correct the entropion. If there’s corneal damage already, your vet will likely treat the eye together with correcting the entropion. Antibiotic eye drops, eye lubricants, and ophthalmic eye drops are sometimes prescribed to be used several times daily to treat the cornea.
In cases of entropion with severe corneal damage, your vet may prescribe systemic antibiotics and oral pain medications along with topical eye drops to help manage pain and speed up the recovery of the cornea. Your vet will also likely send your pet home in an Elizabethan collar (cone) to prevent self-injuries while the wound is healing.
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