CONDITION

Entropion

Why this matters now

Entropion may be present from birth in predisposed breeds, though it often becomes apparent as the head and facial features mature during the first year of life. It can also develop secondary to chronic eye conditions, scarring, or muscle changes at any age. Breed-related conformational entropion is common in certain breeds including Shar Peis, Chow Chows, Bulldogs, and brachycephalic breeds.

The condition typically begins with mild inward rolling of the eyelid margin that may initially cause intermittent irritation. As the rolled eyelid causes ongoing corneal contact, more significant inflammation and discomfort develop. Chronic cases can lead to corneal damage including ulceration, scarring, and pigmentation that may permanently affect vision. The degree of inward rolling may worsen over time, particularly in growing animals.

Signals & patterns

Early signals

Excessive tearing or watery eyes

Irritation from eyelid contact stimulates tear production as a protective response.

Mild squinting or increased blinking

Discomfort causes animals to partially close the affected eye, particularly in bright light.

Visible hair touching the corneal surface

The rolled eyelid brings eyelid hair or eyelashes into contact with the eye.

Rubbing or pawing at the eye

Animals may attempt to relieve discomfort by rubbing the affected area.

Later signals

Marked squinting or holding the eye closed

Significant discomfort or corneal damage causes persistent partial or complete eyelid closure.

Mucoid or purulent discharge

Secondary bacterial involvement may cause thicker, coloured discharge.

Visible corneal cloudiness or pigmentation

Chronic irritation can cause the normally clear cornea to become hazy or develop brown pigmentation.

Corneal ulceration

Persistent friction from hair against the cornea may cause painful erosions of the corneal surface.

Click to read about the biological mechanisms

How this is usually investigated

Diagnosis is typically made through careful ophthalmic examination. Further assessment determines the severity and identifies any secondary corneal damage.

Visual examination of eyelid position

Purpose: To assess the degree of inward rolling and which portions of the eyelid are affected
Considerations: Examination before and after topical anaesthetic helps distinguish primary entropion from spastic entropion caused by pain.

Fluorescein staining

Purpose: To detect corneal ulceration or epithelial damage from hair contact
Considerations: Uptake of the green dye indicates corneal surface damage that may require specific treatment.

Slit lamp biomicroscopy

Purpose: To examine the cornea in detail for scarring, pigmentation, or vessel ingrowth
Considerations: Provides magnified view of corneal changes and helps assess the extent of chronic damage.

Assessment of tear production

Purpose: To identify any concurrent dry eye that may contribute to corneal problems
Considerations: Schirmer tear testing may be relevant as some breeds prone to entropion also have reduced tear production.

Evaluation of facial conformation

Purpose: To understand the underlying anatomical factors contributing to the condition
Considerations: Helps predict likely progression and informs surgical planning.

Options & trade-offs

Management aims to correct the abnormal eyelid position and address any secondary corneal damage. Approaches vary depending on severity and whether the animal is still growing.

Temporary tacking or sutures

Sutures placed to evert the eyelid as a temporary measure, often used in young growing animals.

Trade-offs: Avoids permanent surgery in animals whose facial conformation may still change. May need repeating. Some scarring may help long-term.

Surgical correction

Procedures that remove a crescent of skin and muscle to permanently correct eyelid position.

Trade-offs: Provides definitive correction. Best performed when facial growth is complete. Over- or under-correction can occur and may require revision.

Medical management of secondary effects

Lubricants and medications to protect the cornea and treat any ulceration.

Trade-offs: Addresses consequences but not the underlying cause. Ongoing treatment may be needed until surgical correction is performed.

Multiple staged procedures

Planned sequential surgeries for severe cases or breeds with marked conformational issues.

Trade-offs: May achieve better outcomes in complex cases. Involves multiple anaesthetics and recovery periods.

Common misconceptions

Misconception:

"Puppies will grow out of entropion"

Reality:

Whilst facial maturation may slightly alter the degree of entropion, significant cases rarely resolve spontaneously. Delaying assessment risks ongoing corneal damage.

Misconception:

"Entropion surgery is purely cosmetic"

Reality:

Surgical correction addresses a painful condition that causes ongoing corneal irritation and potential vision loss. It is a functional rather than cosmetic procedure.

Misconception:

"Eye drops can cure entropion"

Reality:

Medications can provide temporary comfort and protect the cornea, but cannot correct the structural eyelid abnormality. Definitive treatment requires surgical repositioning.

Owners noticing excessive tearing, squinting, or visible hair touching their pet's eye surface might consider having the eyelid position assessed. In breeds predisposed to entropion, awareness that this is a common conformational issue can prompt earlier recognition. Noting whether symptoms worsen in certain conditions or if discharge character changes provides helpful information for veterinary discussions.

Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS