Entropion and Ectropion in Dogs

  • By: Mick Whitefield
  • Time to read: 6 min.

Ectropion and Entropion in dogs are two similar eye disorders that generally affect particular breeds. Both conditions affect the eyelids but have opposite symptoms. Dogs with entropion have eyelids that curve inward while ectropion eyelids roll outward.

In this Human example below notice that in the Entropion eye (Left), that the eyelids are reducing the range of vision the eye can see and the lid is rolling inward causing the hairs to aggravate the eyeball.

Entropion Ectropion On Human Eye

In the Ectropion eye (Right) the eyelid is rolling outward which leaves the eye dry and open to external elements such as dust.

Both changes to the eyelids cause problems for the cornea: with ectropion, the cornea gets exposed and easily becomes irritated whereas, with entropion, the eyelid rubs against the cornea and causes irritation. In severe Entropion cases with dogs the eye can appear closed or closing due to the folds of skin.

Entropion Eyelid Being Examined
Closer examination of the Entropion Eye. The lower eyelid is constantly wet and irritating the eyeball due to being folded inward.

What does Entropion look like?

Entropion is a condition in which the margin of the eyelid rolls inwards. It is common in puppies, usually the result of disproportionate eyelid growth. Entropion can be a serious condition with serious health issues such as loss of an eye. It’s, therefore, very important to recognize the signs early to facilitate treatment.

However, by age one, many puppies outgrow the eyelid condition. 

Entropion Eyelid Almost Closed
Entropion eye watering excessively due to irritation from the hairs. Scratching around the eye is the dog scratching at the irritation.

Entropion comes in three forms: genetic/inherited, spastic, and acquired. The most well-known type is inherited entropion and many breeds are susceptible. Most of these breeds, Such as the Chow Chow and Shar-Pei, are known for their drooping eyes or extra” skin folds. Generally, in these breeds, the condition is present at birth.

In acquired entropion, the eyelids tend to roll inward due to changes in the eye or the surrounding muscles. The condition occurs as dogs develop ophthalmic problems or advance in age.

Spastic entropion occurs when the dog experiences any painful condition in the eye such as uveitis or a corneal ulcer. Acquired and spastic entropion can affect any breed and at all ages.

Corneal Ulcer
Corneal Ulcer misshaping the eyeball

The turning in of facial hairs or eyelashes causes irritation and discomfort of the cornea and can result in conjunctiva. Exposure to environmental irritants and the potential of secondary bacterial infection of the conjunctiva can lead to recurrent or long-term conjunctivitis. 

Treatment for Entropion

In most cases surgery is a relatively simple option, a bit like humans having corrective eye surgery for bags or drooping eyelids.

Entropion Eyelid Examined After Surgery
Entropion eye surgery giving a lift to the skin folds.
Something many Humans do simply for their own vanity.

What is Ectropion?

Ectropion is an eye disorder where the lower eyelid appears to ‘roll’ outward. In most cases, the condition affects both eyes. Although there are different possible causes of the disease, the direct or primary cause is the improper development of the dog. Indirect or secondary causes can include diseases previously mentioned in Entropion. 

Ectropion On A Basset
A Basset with Ectropion.
The inner eyelids are exposed because the lower outer eyelid has dropped excessively.

In cases of Ectropion, the lower eyelids appears droopy. Long-term entropion causes abnormal coloring, scarring, and the formation of slow-healing cornea sores because of dryness. Usually, ectropion is diagnosed in dogs under one year of age.

Ectropion may also lead to severe involuntary winking because of pain and scar formation in the area surrounding the eye. The cornea or surface of the eye may also dry out leading to corneal inflammation (keratitis).

Corneal damage not only results in corneal scarring but obstructs or impairs vision. For a dog, these are all very painful conditions.

Early entropion spasms might be reversed if the pain is lessened or their cause is removed. Some ways of reducing the pain include turning the irritating lid hairs away from the eye by stitching the lid, using anesthetics for blocking the eyelid nerves, or injection of medication into the area where the eyelid is turning in.

Sometimes, very young pups with entropion may be treated with temporary stitches that can be removed in about 2-3 weeks. Established entropion will typically require surgery to correct the condition. Where a combination of entropion and ectropion exists, surgery is most frequently performed.

Breeds Affected by Entropion and Ectropion

Both eye disorders are linked to genetic factors with some breeds more predisposed. 

The most common among the two is congenital ectropion, seen in the following breeds.

  • Cocker Spaniel
  • Bloodhound
  • Basset Hound
  • Saint Bernard
  • Bulldog
  • Mastiff
  • Newfoundland
  • Chow Chow
  • English Cocker Spaniel
  • American Cocker Spaniel
  • English Springer Spaniel

Entropion is commonly found among:

  • Retrievers 
  • Great Danes
  • Spaniels
  • Bulldogs
  • Many terriers

Some breeds suffer a combination of both ectropion and entropion. These include Great Dane, Great Pyrenees, Mastiff, Saint Bernard, Newfoundland, and Bernese mountain dog.

Entropion and Ectropion Symptoms

Nearly all dogs with even mild to moderate ectropion or entropion suffer for a lifetime. Typical symptoms include frequent infections, chronic irritation, “dry eye” or corneal ulceration. 

With both conditions, you will notice that the dog’s eyes appear irritated and red. The main observable symptom, however, will be the eyelids.

If they are curving inward, this indicates entropion. Other ectropion symptoms include watery eyes, discharge, and conjunctivitis. Watch also for wet hairs by the eye that are matted down due to excessive discharge and tearing.

These symptoms will result in the animal rubbing at their eyes frequently with their paws.

While entropion causes corneal trauma and significant discomfort in some breeds, others don’t appear to be particularly bothered by the condition.

Curving outward is a symptom of ectropion. The symptoms include visualization of eyelids that are rolled inward, squinting (blepharospasm), excessive tearing, photosensitivity, pawing, and rubbing the eyes.

Some of the common entropion symptoms are watery eyes and conjunctivitis.  In some cases, the dog may experience corneal ulceration and the formation of dark brown pigment on the cornea.

Diagnosing Ectropion and Entropion

Ectropion manifests as an eyelid edge that is turned out, typically with a crack or large notch. Usually, diagnosis is made on physical examination. For an older dog, urine and blood tests may be necessary to pinpoint the underlying cause.

Diagnosis for entropion is through a standard visual exam of the dog along with an understanding of breed-specific tendencies. The pet vet may perform corneal staining to assess the cornea and to determine whether corneal ulceration is present.

Corneal Ulcer 1
Entropion or Ectropion can cause corneal ulcers.

If neuromuscular disease is suspected, the vet may recommend nerve or muscle biopsies.

When looking for underlying entropian causes, testing for antibodies and hypothyroidism may be performed against certain muscle fibers. With both ectropion entropion, the treatment prognosis for the dog is very good.

Ectropion and Entropion Treatment Options

Topical antibiotics may be used to temporarily control infections. Periodic, repeated cleansing of the affected eyelid using mild decongestant solutions may help control mild cases. Often, surgical eyelid-shortening procedures are necessary to resolve the disorders.

Of the two, ectropion is generally the milder condition. Often, it can be managed with eye drops and ointments as they keep the eye moist. In adult dogs, permanent eyelid surgery may be performed to correct the abnormality. Surgery entails shortening the eyelid or removal of a section of tissue around the eyelid margin.

Entropion Surgery On A Retreiver
Corrective Entropion surgery on a Retriever

Over-correcting entropion could lead to complications and is difficult to fix afterward. Dogs with severe entropion are more likely to require multiple surgical procedures. It may require a second surgery if the initial procedure was inadequate. For this reason, vets prefer to be conservative rather than take the risk of removing too much eyelid tissue.

If your pet vet recommends surgical correction of ectropion or entropion, he or she will discuss the benefits and associated risks, and how the specific procedure might impact you and your dog.

With both conditions, the prognosis for the post-treatment is very good. To protect your dog’s eyesight, carefully follow the vet’s treatment program.

Preventing Ectropion and Entropion

Ectropion can be prevented by keeping your pet’s eyes healthy to avoid more serious problems from developing. Certain breeds are more susceptible to ectropion than others hence why it’s also not recommended to breed with dogs suffering from this disorder.

Most often, entropion is seen in purebred dogs and because it often occurs naturally after scarring or with age, the condition is difficult to prevent.  It’s recommended that canines with entropion should not be used for breeding as the mechanism of genetic inheritance is still not well-understood.

The American Kennel Club doesn’t allow the showing of dogs with a history of entropion repair.

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