Entropion

Entropion causes constant ocular irritation because the eyelid never stops rubbing. Signs range from mild to severe depending on how much of the eyelid is rolled and how long the condition has been present:

• Persistent squinting or holding the eye partially or fully closed
• Excessive tearing or tear staining on the face
• Eye discharge (clear to mucoid)
• Rubbing the face on furniture or carpet, or pawing at the eye
• Redness of the white of the eye (sclera)
• A visibly cloudy or hazy cornea — indicating corneal ulceration or scarring from chronic rubbing
• In severe cases, a sunken or shrunken appearance to the eye if secondary damage is extensive

Signs are usually present from a young age in conformationally predisposed breeds, though spastic entropion — caused by painful squinting from another eye problem — can develop at any age.

Entropion has several distinct forms, and identifying the type directs treatment appropriately:

• Conformational (primary) entropion — the most common type; results from excess facial skin, deep-set eyes, or abnormal eyelid tension that is genetically determined. Heavily predisposed breeds include Shar-Peis (often severe and present in puppies), Chow Chows, Bullmastiffs, Rottweilers, Golden Retrievers, Labrador Retrievers, St. Bernards, Bloodhounds, Great Danes, and Basset Hounds
• Spastic entropion — secondary to ocular pain from another problem (corneal ulcer, foreign body, glaucoma); the pet squints so forcefully that the eyelid rolls in. Resolves if the underlying problem is treated, but persistent spasm can lead to conformational entrainment
• Cicatricial entropion — scarring of the eyelid from prior trauma, infection, or chronic inflammation pulls the margin inward; less breed-specific
• Cats can develop entropion, most commonly secondary to chronic conjunctivitis (especially from feline herpesvirus) or as a conformational issue in Persians

Diagnosis is clinical — the rolling eyelid is visible on examination. The critical steps are to determine the type of entropion, the extent of corneal damage, and whether the condition is the primary problem or secondary to another eye disease:

• Fluorescein staining reveals corneal ulcers or erosions caused by the chronic lid-to-cornea contact
• Schirmer tear test checks whether concurrent dry eye is present, since entropion and KCS sometimes coexist in the same breeds
• Careful examination for a foreign body, ulcer, or source of pain that could be driving spastic entropion before committing to surgery
• In young puppies with Shar-Pei-type entropion, temporary tacking sutures may be placed first to protect the cornea while the puppy grows, with definitive surgery scheduled later

Permanent correction of conformational entropion requires surgery. The Hotz-Celsus procedure — removal of a carefully measured ellipse of skin just below (or above) the affected lid margin — rolls the eyelid back to its correct position. The approach varies by lid location and degree of rolling:

• Lower lid entropion — most common; corrected with a Hotz-Celsus skin resection below the lower lid
• Upper lid or lateral canthus entropion — requires anatomically adjusted incision patterns; complex cases may combine techniques
• Medial lower lid entropion — common in brachycephalic breeds alongside nasal fold irritation; sometimes addressed together with other conformational corrections
• Temporary tacking (in puppies) — sutures that evert the eyelid temporarily, protecting the eye until the puppy's facial conformation matures enough for definitive repair, usually after five to six months of age

When a corneal ulcer is present, that is treated concurrently with antibiotics and pain relief. Eye lubricants help protect the cornea before surgery and during healing afterward.

If your dog is squinting chronically, has persistent eye discharge, or has an eyelid that looks like it's turning in, schedule an evaluation soon — not eventually. Every day of corneal rubbing adds scar tissue that won't fully reverse even after the entropion is corrected. Owners of Shar-Peis, Chow Chows, Rottweilers, and other predisposed breeds should have puppies' eyes checked early, since these breeds often need temporary eyelid tacking in the first weeks of life. The team at Dog & Cat Hospital Calabasas can assess the eyelids, check for corneal damage, and plan the right correction for your pet's anatomy. Book an appointment today.