Goals of Treating Entropion
Entropion is extremely painful. Severe developmental entropion will not improve without treatment, and the symptoms will worsen with time. If left untreated, entropion can lead to corneal scarring, erosion, ulceration, rupture and eventually blindness. The goals of treating this disorder are to relieve chronic irritation and pain, resolve any underlying causes of the condition and prevent further damage to affected eyes. Treatment can include temporary correction - especially in puppies - or permanent correction, once adult conformation is reached and underlying problems (corneal abrasions, ulcers, conjunctivitis, etc.) are resolved.
Dog owners can alleviate some of the symptoms of entropion by applying eye drops, ointments or other types of topical lubrication. However, the only truly effective treatment for entropion is surgery.
Puppies with congenital entropion should not undergo permanent surgical correction until they are adults, because as they mature their facial features and structure will change. In mild cases, topical antibiotic ointments and artificial tears or lubricating eye drops may be appropriate. In more severe cases in young dogs, the veterinarian may recommend temporary surgical correction with a “tacking” procedure that involves rolling the affected eyelids away from the eye and holding them in place with sutures (“stitches”). This procedure may need to be repeated periodically as the animal grows and its facial conformation changes. In some cases, temporary surgical correction will actually resolve the condition, making surgery as an adult unnecessary. Temporary tacking is especially common and effective in very young Shar-Pei puppies, which can manifest entropion by 2 to 6 weeks of age.
Once a dog has reached maturity, permanent surgical repair of entropion can be considered to restore normal eyelid conformation. There are several different surgical techniques to accomplish this correction, but they all involve everting the eyelid margin away from the globe of the eye (the eyeball) by removing a portion of the eyelid and pulling together and suturing (stitching) the remaining parts.
The prognosis for dogs that have had entropion surgically corrected is very good to excellent, as long as the treatment takes place before their eyes are permanently damaged. Periodic treatment with antibiotic or lubricating drops, creams or ointments may be appropriate if infection or inflammation recur. The veterinarian probably will recommend that the dog wear an Elizabethan (“cone” or “lampshade”) collar post-operatively, to reduce the risk of disruption of the surgical site from pawing or rubbing. Follow-up visits to the veterinarian will be important, both to remove sutures and assess progress.