Entropion Repair

Entropion does not resolve on its own, and medical management — lubricating eye drops — only partially alleviates the discomfort without addressing the cause. Chronic corneal irritation from entropion leads to:

• Corneal ulceration — open sores on the surface of the eye
• Corneal scarring (pannus) that permanently affects vision
• Corneal perforation in severe or neglected cases
• Chronic pain and behavioral changes from constant eye discomfort

Surgery is the definitive treatment and is recommended once the diagnosis is confirmed in a fully mature pet. Puppies may receive temporary sutures (tacking) to protect the eye while the face develops to its adult conformation before permanent repair.

Entropion repair (the Hotz-Celsus technique is the most widely used) is performed under general anesthesia. The steps:

• The precise width and length of the skin to be removed is carefully measured — this planning step determines the final eyelid position
• A crescent-shaped strip of skin and subcutaneous tissue is excised from just below (or above) the affected eyelid margin
• The wound is closed with fine sutures that evert (roll outward) the eyelid edge to its correct position
• The same technique is applied to the upper or lower lid independently, or both, depending on where the entropion is located

In complex cases or breeds with severe facial skin folding, additional procedures — such as medial canthoplasty to narrow the corner of the eye — may be combined at the same time.

Before surgery, the full extent of the entropion is assessed and the cornea is stained with fluorescein dye to reveal any ulcers that need treatment concurrently. Pre-anesthetic bloodwork is run. If a corneal ulcer is present, topical antibiotic eye drops may be started before surgery. The pet should be at adult facial conformation before permanent repair — typically 12 months for smaller breeds and 18–24 months for large and giant breeds whose faces continue to develop longer. Food is withheld the night before the procedure.

Entropion repair is a day procedure. Recovery is straightforward:

• Days 1–10: e-collar worn at all times to prevent rubbing; prescribed antibiotic and anti-inflammatory eye drops administered
• 10–14 days: suture removal at a recheck visit; the eyelid position and corneal surface are assessed
• 2–4 weeks: the eye should be open, clear, and comfortable; any corneal scarring from prior irritation lightens over subsequent months

The improvement in comfort is usually obvious within the first few days after suture placement — pets that previously squinted constantly often open their eye fully for the first time in months.

Entropion repair is highly effective, and the main technical risk is over- or under-correction. Undercorrection (residual inward rolling) may require a second, smaller revision procedure. Overcorrection (ectropion — outward rolling) exposes the conjunctiva and can cause its own irritation. Precise surgical planning minimizes both outcomes. Breeds with extreme skin folding — Shar-Peis, Chow Chows, giant breeds — may require staged procedures or more extensive reconstruction. Infection of the suture line is uncommon. Even after successful repair, corneal scarring from prior entropion is permanent, though it often fades partially over time as the eye remains comfortable.