Entropion is an inward rolling of the eyelid edges. This is a common eye problem and can be present soon after birth or acquired later in life. It most commonly affects the lower eyelids.
Entropion that is considered to be inherited usually develops within a few months of birth. It occurs in a wide variety of purebred dogs, including the chow chow, English bulldog
, Irish setter, Labrador retriever, St. Bernard, Chinese shar-pei, golden retriever
, Great Dane, and Chesapeake Bay retriever.
Entropion may also develop later in life secondary to other changes around the eye. It can arise from spasm and pain associated with corneal and other eye diseases. It may occur when the eye itself moves backwards into the orbit (enophthalmos), or when the eye becomes shrunken following a severe injury or infection. Occasionally entropion develops following loss of normal neurologic function of the eyelids.
Entropion can occur alone or may be accompanied by other eye problems such as abnormal eyelashes, corneal ulcers and scarring, and ectropion (outward rolling of the eyelid). Since entropion is the inward rolling of the eyelid, the hair on the affected lid continuously rubs against the cornea. This can cause significant discomfort and trauma to the cornea.
Entropion most often affects the outer aspect of the lower eyelids of one or both eyes. The upper eyelids may also be involved. In some dogs the entire eyelid is rolled inward, or a portion of the lid may be rolled in and another portion is rolled out. What to Watch For Tearing
Squinting, inability to see the eye well
Mucoid or thick discharge from the eyes
Rolling of the eyelid and wetness on the hairs adjacent to the eyelids
Diagnosing entropion is done by a thorough ocular examination.
The position of the eyelid is often assessed before and after the application of a local anesthetic solution.
Careful examination of the edges of the eyelid may reveal ingrown eyelashes or abnormally placed eyelashes.
Fluorescein dye is used to detect any corneal ulcers that may be present due to the constant rubbing of the eyelashes against the cornea. Fluorescein adheres to damaged sections of the cornea and appears bright green. If left untreated, the cornea may develop excessive scar tissue in an attempt to protect the eye from the constant abrasion caused by the eyelashes. With treatment, this scar tissue usually resolves.
Other components of the eye are also examined to ensure there are no underlying causes of the entropion and that no other defects or abnormalities accompany the entropion.
There is no medical therapy to correct the entropion itself; surgical correction is necessary. An important part of surgical correction of entropion is to make sure your veterinarian has experience in these procedures. Overcorrecting entropion can have serious repercussions. The eyelid may then roll excessively outward or may not be able to close completely. Both these complications can result in irritation of the cornea, and may require either further surgery or a lifetime of protective eye medications.
Based on the severity of the entropion, breed and age of the pet, different surgical techniques may be used.
A temporary measure that is sometimes used in shar-pei and other puppies is an eyelid "tacking" procedure to prevent damage to the cornea as the dog grows. This involves placing sutures in the affected eyelids that pull the eyelids outward. Skin staples may be used instead of sutures. These sutures usually remain in place for 7 to 10 days. This procedure is most often used when entropion is encountered soon after the eyelids open. At this age, the growth rate is so fast that the entropion may disappear within the time period that the sutures or staples are in place. There is no skin removed in this procedure.
Occasionally tacking is performed as a temporary procedure to help in the healing of corneal ulcers, and to try to resolve entropion that has developed secondary to the spasm caused by the pain of the corneal ulcer. It is rarely performed in dogs older than 6 months of age.
Another surgical option involves removal of skin from the eyelid, near the eyelid margin. This allows for more permanent correction of the entropion. Several different procedures may be utilized, depending upon how severe the entropion is, what area of the lid is affected, and whether there are other defects that must be corrected at the same time. The goal of surgery is to return the lid to a more normal position and to keep the hairs of the eyelid from rubbing on the cornea.
Home Care and Prevention
Home care associated with entropion usually involves administering medication for corneal ulcers. After surgery, your dog will usually be sent home with an Elizabethan collar to prevent him from pawing or rubbing at the eyes. Keep this collar on your pet at all times. Examine your dog's eyes frequently and make sure there is no evidence of excessive tearing or pain (squinting). Frequent rechecks may be necessary to make sure the eyes continue to heal properly.
Sometime, topical antibiotics are prescribed. Administer the medications as instructed and inform your veterinarian if you are having trouble medicating your pet. Sutures are typically removed in 10 to 14 days.
If corneal damage has occurred, repeated examinations by your veterinarian can help determine if your pet is improving or needs additional treatment.
Entropion is considered an inherited condition in most purebred dogs. It is recommended that dogs with entropion not be used for breeding. This may decrease the incidence of this disorder within the breed.