N E B K C

Eye conditions 

Bulldogs and other brachycephalic breeds are often afflicted with common eye problems as: Entropion, Ectropion, Ectopic Cilia (Eyelashes) and "Cherry eye" and . "Cherry eye" is the popular term used for the prolapse (sticking out) of the gland of the third eyelid in dogs.

 

ENTROPION

Entropion is a condition in which the eyelids roll inward, allowing the eyelashes or other hair to rub against the cornea and irritate it. The upper and/or lower eyelids can be affected and the condition can occur in either one or both eyes. In some dogs, entropion is never more than a minor annoyance, but in others it can cause corneal ulcers that can lead to scarring and affect vision. When there is a genetic factor causing entropion, as in English bulldogs, it can be seen well before the dog's first birthday. Medical treatment with ophthalmic ointments can decrease damage to the cornea, but it cannot resolve the entropion itself. To permanently fix the eyelid, surgery is needed. The surgery is a procedure called blepharoplasty. In this procedure, the excess skin of the outer lids is removed. In some cases, excess skin that causes skin folds around the eyes is also removed. Recurrence is extremely rare. The healing time for this surgery is 10 to 14 days. Blepharoplasty is typically not performed on puppies less than 6 months of age because it is not possible to predict what the adult head conformation will be at that age, and therefore whether surgery would be warranted. Temporary eyelid tacking can be performed in younger puppies until they mature and grow into their adult facial features.

ECTROPION

Ectropion is a common condition of dogs where the lower eyelids droop or roll out. It can affect one or both eyes. It is often inherited and has a strong tendency to occur in dogs with loose droopy skin. Hereditary or developmental ectropion is most common in young dogs whereas acquired ectropion can develop as a result of nerve damage or injury and can occur with corneal injury, infection or other severe inflamatory conditions. 

Symptoms of ectropion
Affected dogs have:

  • Droopy lower eyelids

  • Redness and inflammation of the conjunctiva

  • Excessive tearing

Eye infections can result from the exposure of the lower conjunctiva.

Diagnosis of ectropion
In most cases the condition can be confirmed by visual examination. A thorough examination of the eyelids is important since ectropion can often occur in conjunction with entropion (Click here to learn about entropion.) which makes the condition more complicated to manage. 

 

Treatment of ectropion


Ectropion is relatively well tolerated unless it is severe and surgical repair can generally be  avoided by treating inflammation with a variety of eye drops. Most cases of ectropion that are not severe will require little if any intervention other than topical drops and ointments.  Extremely severe cases of ectropion will not improve without surgical repair. There are several surgical procedures that may be used to reduce ectropion.
 

Prognosis of ectropion


In all but the most severely affected cases the prognosis is quite good. The condition is generally well tolerated and in most cases will respond to simple medical care. Surgical correction may be required in severe cases. Though the surgery is relatively simple it can be very delicate and requires an experienced surgeon

CHERRY EYE 

In certain breeds this gland is not strongly held in place and can stick out abnormally. When it is out of its normal position the gland gets improper circulation and may swell. Historically the prolapsed gland was treated by surgical removal, but this was eventually shown to lead to a condition called dry eye in which the tear production for the eye is inadequate. The dry eye condition is uncomfortable and typically affects the vision as well. The current treatment for cherry eye is surgical replacement of the prolapsed gland. A wedge of tissue is removed from directly over the gland and this is used to create a pouch into which the gland is tucked and sutured closed. Sometimes the tuck is not anchored well enough to hold permanently, and it is not uncommon for a second tuck to be needed. 

Complications of cherry eye surgery may include: inflammation or swelling around the eye as the stitches dissolve; inadequate tightening of the pouch leading to recurrence; and loose stitches that may cause discomfort in the eye. Some post-operative swelling after cherry eye surgery should be expected, but this should resolve and the eye should be normal in appearance after about one week. 

ECTOPIC CILIA (EYELASHES)

A cilium is a hair, and ectopic means growing out of place. Ectopic cilia are one or several hairs that grow abnormally through the conjunctiva and come into contact with the surface of the eye (cornea). These abnormal hairs most commonly occur on the upper middle eyelid.

"The offending hairs rub against the cornea, often causing intense pain and corneal ulcers."

The offending hairs rub against the cornea, often causing intense pain and corneal ulcers. These abnormal hairs must be removed or serious damage to the eye may occur. Ectopic cilia are most commonly diagnosed in young dogs and are very rare in cats.

Ectopic cilia are not the same as distichia. Distichia are extra eyelashes that, due to abnormal conformation, rub against the cornea. Some breeds such as the American Cocker Spaniel normally have long eyelashes that may contact the cornea but cause no problem. When distichia causes corneal irritation or discomfort, they should be surgically removed.

What are the clinical signs of ectopic cilia?

The clinical signs associated with ectopic cilia are those associated with corneal ulcers and eye pain. The eye and conjunctivae may appear reddened or inflamed with excessive tearing or discharge.

"The dog rubs or paws at the eye because it is uncomfortable."

The dog often rubs or paws at the eye because it is uncomfortable. Affected dogs often hold the eye tightly closed and blink uncontrollably (blepharospasm).

 

How are ectopic cilia diagnosed?

Diagnosis is usually made on physical examination. Some dogs will require topical anesthetics or sedatives to relieve the intense discomfort and allow a thorough examination of the tissues surrounding the eye (eyelids, eyelashes, tear ducts, third eyelid, etc.). Corneal staining will be performed to assess the cornea and to determine if any corneal ulceration is present.

How is the condition treated?

The treatment for ectopic cilia involves surgical removal of the offending hairs. The problematic hairs can be removed surgically using a scalpel or punch biopsy, as long as enough of the surrounding tissue is also removed. Alternatively, cryosurgery (freezing) can be used to effectively kill the follicle. Any secondary corneal ulcers will be treated with topical ophthalmic antibiotics and systemic pain medications. An Elizabethan collar (E-collar or cone) may be worn to prevent self-trauma.

What is the prognosis for ectopic cilia?

The prognosis for surgical correction of this condition is generally good. Some dogs may develop additional ectopic cilia later in life that will also require surgical removal. Your veterinarian will discuss a diagnostic and treatment plan for your dog to help you successfully treat this condition.

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