Eyelid Entropion in Dogs

What is entropion?

Entropion is an abnormality of the eyelids in which the eyelid rolls inward. This inward rolling often causes the hair on the surface of the eyelid to rub against the cornea, resulting in pain, corneal ulcers, perforations, or pigment developing on the cornea, which can interfere with vision.

Entropion is usually a developmental or anatomic problem, and is generally seen in young, rapidly growing dogs. It can, however, develop secondary to an eye irritant, such as a corneal ulcer, that can cause the eyelid to spasm. It can also occur following an injury or inflammation that leads to scarring that turns the eyelid inward.

What are the signs of entropion?

Most dogs will squint, hold the eye shut, and tear excessively (epiphora), though some patients will develop a mucoid discharge (“goopy eye”). Interestingly, many flat-faced dogs with medial entropion (involving the corner of the eyes near the nose) exhibit no obvious signs of discomfort. In most cases, both eyes are affected. It is usually diagnosed in puppies under one year of age.

"Entropion is usually a developmental or anatomic problem, 
and is generally seen in young, rapidly growing dogs."

Severe cases, where the eyelid hairs and eyelashes have been rubbing on the eye for a long period of time, can result in blood vessel or pigment growth of the cornea. These dogs may be depressed and showing obvious pain.

Are certain breeds more likely to have entropion?

Entropion is considered a hereditary disorder. While the exact genetics are unknown, many breeds are identified as having this problem. These breeds include the blood hound, bull mastiff, Chesapeake Bay retriever, Chinese shar pei chow chow, Clumber spaniel, doberman pinscher, English bulldog, golden retriever, goldendoodle, Gordon setter, Great Dane, Irish setter, Labrador retriever, Neapolitan mastiff, rottweiler, and standard poodle.

In the case of secondary entropion, the condition can occur in any age or breed.

How is entropion treated?

The treatment for entropion is surgical correction. A section of skin is removed from the affected eyelid to reverse its inward rolling. In many cases, a primary, major surgical correction will be performed, and will be followed by a second, minor corrective surgery later. Two surgeries are often performed to reduce the risk of over-correcting the entropion, resulting in an outward-rolling eyelid known as ectropion. Most dogs will not undergo surgery until they have reached their adult size at six to twelve months of age.

In the case of young puppies (especially in certain breeds like the Chinese shar pei or chow chow), temporary sutures may be placed to roll the eyelids outwards. As the puppy grows, the entropion is monitored to see if resolves on its own. If it doesn’t, then a more definitive surgery can be done at four to five months of age.

Some cases of entropion have been successfully treated, temporarily, using injections of hyaluronic acid (HA). This thick filler material is used to evert (roll outward) the eyelid margin by plumping up the tissue around the area of the entropion. This treatment has been recommended for pets at high general anesthesia risk, as it can be done with minimal sedation in many cases.

Both prior to surgery and after surgery, ophthalmic medications such as antibiotics and artificial tear lubricants may be used to help treat secondary problems that have developed and to protect the cornea, respectively.

What is the prognosis for entropion?

The prognosis for the surgical correction of entropion is generally good. While several surgeries may be required, most dogs enjoy a pain-free, normal life. If the condition is treated later and corneal scarring has occurred, there may be permanent, irreversible visual deficits. Your veterinarian will discuss a diagnostic and treatment plan for your dog to help you successfully treat this condition.

Should an affected dog be bred?

Due to the concern of this condition being inherited, dogs with severe ectropion requiring surgical correction should not be bred.