Entropion

Patty Khuly

Summary

Entropion is a common disease of the eyelids in which the lower or upper lids roll inwards. This abnormal conformation of the eyelids is considered an undesirable inherited trait as it typically leads to pain and swelling of the eyes as a result of irritation caused by eyelash and other eyelid hair impingement on the cornea (the outer layer of the eyeball).

Corneal ulcers are a common sequel of entropion and may lead to severe pain, vision impairment due to scarring and loss of the integrity of the entire eye, which can lead to enucleation (eyeball removal).

Dogs bred for heavy facial folds and a “droopy eye” look are most commonly affected. It is considered very rare in cats.

Symptoms and Identification

Entropion is an obvious conformational change even most uneducated owners will note readily. Full evaluation of the eye is necessary, however, before medications or other treatments are employed. This is due to the propensity for corneal ulceration and the potential for inappropriate choice of medications.

A veterinarian will typically anesthetize the eye (because it is often painful) and stain the cornea to determine integrity or ulceration before electing a treatment regimen. Ophthalmologists are often enlisted, especially in severe cases, after general practitioners have diagnosed the condition and assessed its severity.

Both eyes are typically involved.

Affected Breeds

Entropion is an issue for the following breeds:

Entropion is also common to giant breeds such as:

Some of these larger breeds may suffer a simultaneous combination of entropion and ectropion.

Treatment

The ideal treatment for entropion depends on its severity but most often relies on surgical intervention to correct the lid deformity. This kind of plastic surgery (called “blepharoplasty”) requires the precise excision of a crescent shaped bit of tissue over the affected lid(s) to rotate the lid outwards.

Some dogs require multiple surgeries, particularly in the severely affected or in young, growing dogs whose lids may change in conformation as they age.

If the entropion is evident at a very young age, some veterinarians will advocate a more simple procedure called “lid tacking.” In this approach, a stitch is placed above or below the lid or both (depending on the lids affected) in the hope that as the lids develop they will do so in a “rolled out” fashion. This approach is not always effective in the long term.

Alternatives to entropion surgery for dogs with excessive skin fold above the eyes include “brow lifting” procedures that require permanent implants. This approach is not readily available and is currently being researched for its viability.

Veterinary Cost

Blepharoplasty can be a $300 to $500 proposition if performed by a general practitioner. Ophthalmologists and veterinary surgeons may charge between $500 and $1,500. Owners should be aware that results of this surgery will vary, typically according to the veterinarian’s experience with blepharoplasty procedures and surgery in general.

Prevention

Affected dogs should not be bred. Indeed, breeding is limited in dogs that are shown for conformation as tacking and blepharoplasty disqualifies them from competition. Predisposed breeds can elect CERF testing, which is an annual certification process that helps breeders determine which dogs carry ophthalmic-related genetic traits.



References

Slatter, D. 1993. Textbook of Small Animal Surgery. p. 856-889. W.B. Saunders Co., Toronto.