Veteran pet owners know to check an animal’s skin for lumps or abscesses, monitor its eating and digestive habits and even observe its breathing and motor skills at rest and play. But there’s a tiny area many of us forget to examine: the eyelids. Eyelid disorders can cause pain and vision problems and, in rare cases, threaten a pet’s health.

Eyelid disorders most frequently affect the comfort of the eyes in dogs and cats, causing corneal ulcers or abrasions. Many such conditions are genetic and develop in very young animals, but others come along later in life. This is your guide to the most common ones.

Troublesome Eyelid Hairs

Entropion of the lower eyelid in a cat before surgery

Entropion of the lower eyelid in a cat before surgery

Entropion is a condition where eyelids curl inward, constantly rubbing bristly hairs on the surface of the cornea. Ophthalmologists can treat very young dogs with a minimally invasive tacking procedure, which temporarily corrects the issue; these pups may grow out of the condition as they age. However, most dogs and cats require surgery to permanently fix the problem. The most common technique involves removing a strip of skin from the eyelid and suturing the gap closed, which rolls the lid back into a normal position.

Resolution of the entropion of the cat after surgery

Resolution of the entropion of the cat after surgery

A cilium is a hair, and “ectopic” means “growing out of place.” In ectopic cilia, one or several hairs grow through the underside of the conjunctival surface of the eyelid. These hairs, typically very bristly, rub on the cornea, causing a great deal of discomfort and corneal ulcers. Surgical excision of the hair and associated hair follicles resolves the discomfort and heals the ulcer.

Hairs Growing in the Wrong Places

Ectopic cilia (under the eyelid) and distichia (on the eyelid margin)

Ectopic cilia (under the eyelid) and distichia (on the eyelid margin)

Eyelashes normally grow on the outer part of the eyelid, where skin is present. In distichiasis, sometimes known as “double eyelashes,” they grow along the eyelid margin that contacts the cornea. These hairs rub constantly on the corneal surface when the animal blinks, leading to excessive tearing, discomfort, and ulceration.

Distichia

Distichia

Removal can be tricky, since damage to the eyelid margin can lead to future irritation of the cornea. Ophthalmologists usually use cryotherapy for this condition: It freezes and kills rapidly growing hair follicles to prevent future regrowth, and it preserves the health of the normal eyelid tissue.

Trichiasis, most commonly found in dogs, involves normal facial hairs directed toward the eye, creating irritation, tearing, rubbing and corneal ulceration. You see this most often in Shih Tzus, Pekingese and other breeds with prominent eyes and long facial hair. An ophthalmologist fixes the problem with surgical resection of offending hairs or skin, cryotherapy or even laser removal.

Eyelid Styes and Tumors

A chalazion or external hordeolum (both often called a stye) can arise when oily meibomian glands in the eyelid become impacted or infected, leading to swelling and discomfort. Some swellings can be treated with topical and/or oral antibiotics, warm compresses and anti-inflammatory medications. Others require lancing with a scalpel blade or laser to express the compacted material.

Dogs and cats can develop many types of tumors on the surface of the eyelid and eyelid margin. Most are benign and originate from the meibomian glands within the eyelid or the eyelid skin. Unfortunately, a small percentage behave in a more malignant or aggressive way to jeopardize the health of the eye.

Treating Eyelid Tumors

Even a benign tumor may grow over time to rub on the corneal surface and cause irritation. Other tumors may swell, bleed and become painful, but several treatment options exist. The most common involves a full-thickness surgical excision of the tumor, followed by suturing of the eyelid defect to restore full eyelid function and good cosmetic appearance.

While this option works well for many animals, it requires general anesthesia and owners of elderly dogs or cats may feel that’s too risky. Fortunately, ophthalmologists at CARE routinely perform laser and cryotherapy removal of these masses, using only mild sedation and local numbing agents.

This method lowers the risk to the patient, maintains its comfort level and has a high rate of success in permanently solving the problem. CARE ophthalmologists can also biopsy the animal and work with an in-house oncologist for further advice or treatment as needed.

We see all types of eyelid disorders at CARE. If you or your primary veterinarian notice any eyelid problems, please arrange for an exam by our ophthalmology team.

Think of Charlotte Animal Referral and Emergency as the pet version of a medical center for people. CARE stays open 24 hours a day, every day of the year. It offers every type of treatment, from emergency care to board-certified specialty work, after a referral from your primary care veterinarian. You can take a visual tour of the practice at carecharlotte.com/tour.

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