Eyelid abnormalities in dogs can be serious business, not just because of the abnormal appearance to the eyes when these things happen, but also because of the secondary irritations and abrasions they can cause the eyes.
Veterinarians commonly see three lid issues that warrant surgical treatment: Cherry eye, Entropion and Ectropion. I'll cover all three today: not just why they happen, but how we correct them.
Cherry Eye, or third eyelid hyperplasia, is very common in both puppies and mature dogs. This condition can happen in almost any breed of dog.
In most cases, it results from the gland of the third eyelid expanding to a greater size than anatomically acceptable, and then not shrinking back down to a size that can be accommodated under the lower eyelid (back where it belongs).
This red, fleshy-appearing raised "blob" often comes up rather suddenly, from the lower-inside corner of the eye. The condition needs to be shored up surgically, because of the irritation the expanded gland can create from friction to the cornea on repeated blinks.
Veterinarians commonly utilize the "pocketing technique" to tuck the third eyelid down below the lid line, thus decreasing the likelihood of any recurrence, while preserving the tear film the third eyelid contributes to the long-term welfare of the corneal surface.
At that point, the "blob" is out of sight and out of mind, and no doubt, the dog in question can see better. Medical treatment of these cherry eyes with salves or drops is seldom of any benefit to the patient.
Entopion is when the eyelids (upper, lower or both), curl inward toward the eye, therefore creating a rubbing, irritating problem because of the hair of the lids turning inward on the cornea.
Entropion is most common in Chinese shar peis, chows, retrievers, great Danes, bullies and mastiffs. Entropion is considered inherited in most cases.
Entropion often is seen in puppies, but this lesion can enter the picture later on if tissues around the eye continue to grow with time.
These lesions can sometimes get so severe that affected dogs can get not only corneal ulcers but also closed eyes completely from the deep pain it causes. The fix on these patients is to perform a plastic surgery of sorts by removing strips of skin from above and below the eyes so as to tighten the skin with sutures pulling away the skin from the eyes.
This in turn pulls the hair off the cornea of the eye, therefore easing the long-term irritation. Corneal abrasions or ulcers are also medically treated as they after the primary cause is repaired.
Shar peis sometimes have such radical amounts of excessive skin causing the entropion, more than a strip-actually thick chunks of skin-must be removed in order to reduce the irritation to the eyes.
Ectropion is the opposite of entropion, when the upper or lower lids of the dog (most noticeable are the lower lids) bag out loosely, therefore exposing a lot of redness of the conjunctival tissues behind the eyelid. These lesions are considered to be developmental, not inherited, and manifest themselves commonly by one year of age.
Breeds affected include bloodhounds, bassets, St. Bernards, Newfoundlands and cocker spaniels. An occasional veterinarian-created lesion of ectropion may be from over-correction of an entropion. Ectropions are the lesser of the two evils medically.
Most of the time, a simple wedge resection on the lower corner of the eye, so as to create a "lid tightening" is sufficient to fix the problem. Admittedly, many of my clients allow their dogs to live with some of these ectropions untreated. Medical treatment of ectropions (apart from surgery), may be necessary if redness or tearing becomes excessive.
This has been a general practitioner's overview of three common eyelid abnormalities I see in practice. While I am comfortable performing the repair of these conditions, some clients (and veterinarians) prefer to consult an eye specialist for dogs before proceeding with any surgical repairs.
Ask your pet's veterinarian which road he or she would like you to take, should one of these conditions be diagnosed in your dog.
Dr. Chris Duke is a veterinarian at Bienville Animal Medical Center in Ocean Springs, Miss. Questions for this column are encouraged. Write to South Mississippi Veterinary Medical Association, 20005 Pineville Road, Long Beach MS 39560 and include a self-addressed stamped envelope.