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ENTROPION: How Eyelashes Can Cause Vision Loss

Updated: Nov 19, 2021

A stray cat kept coming to our sanctuary several years ago, as many stray and feral cats do. We named him Ze. His eyes got worse by the day. When we were finally able to get him to come to us, we took him straight to the vet. He was diagnosed with entropion. (The photo above is before and after surgery)

Entropion can be a hereditary condition, in which the eyelashes are turned inward toward the eyeball. It can also develop later in life, because of changes to the eye. Although it can occur in both the upper and lower eyelid, it is more common in the lower. The eyelashes can scratch the cornea, the outside clear layer of the eye, which controls and focuses the entry of light. The constant rubbing can cause irritation that can lead to corneal ulceration and even cornea perforation in more severe cases. In healing from the perforation, a dark scar can be left behind, impeding vision.

Entropion is more common in dogs than in cats.

Common symptoms of entropion include:

  • Excess tearing (runny eyes)

  • redness and swelling of eye lid

  • tissue around the eye may be sagging

  • light sensitivity

  • yellow discharge may indicate an infection as a result of the irritation

  • change in the appearance of the eye

  • squinting

In dogs, the entropion is consider a genetic-related condition and can be found in certain breeds more often than others. In brachycephalic breeds (short-nosed breeds) with medial entropion (corner nearest the nose), the condition rarely causes irritation. The reason is unknown.

The number one cause of hereditary entropion in cats is facial shape. In brachycephalic cats, there is more tension on the ligament of the inner eye. This tension, along with the shape of their nose and face can lead to both eye lids turning inward. Yet, another reason brachycephalic cats should not be bred.

Non-genetic related entropion can be caused by repeated bouts of conjunctivitis, the swelling of the pink tissue surrounding the eyes. This can be infection related, or non-infection related. Corneal ulcers are also a cause of entropion. The pain caused by the ulcers can cause the eye lid to spasm, leading to entropion.

If the condition is mild and without complications such as corneal ulcers, regularly administering artificial tears and antibiotic gel may be all that is required for treatment.

However, most often, surgery is required. In the procedure, the eyelid is rolled out to the proper position and tacked down by temporary sutures.

In this closeup, you can see the damage done to the cornea (scrapes and divots). You can also see that the vet has removed a flap of skin in preparation to pulling the eyelid in its intended position. That is accomplished by suturing the top of the cut to the bottom of the cut. This is what it looks like post-surgery:

Remember that our animals can't verbally convey their pain, but one can imagine how irritating and painful it must be the have something scrape their eyes every time they blink. So if your cat appears to have any of the symptoms above, talk to your vet about your concerns. You are your pet's advocate.

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