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What is Entropion in Cats?
Symptoms of Entropion in Cats
Rubbing the eye
Raised third eyelid
Cloudy cornea and ulceration
Causes of Entropion in Cats
Congenital means “present at birth,” and is usually noticed around two weeks of age, when the eyes open for the first time. This is an uncommon form of entropion in cats.
Anatomical, or developmental entropion, is also rare in cats. This type occurs more often with brachycephalic, or short-nosed breeds, and purebred Himalayan or Persians. In these breeds, the eyes bulge more secondary to a shallow eye socket, causing crowding in the face and subsequent inversion of the eyelid. Researchers have also found this type of entropion in cats with a special hyper-elastic connective tissue condition, called Ehlers-Danlos, in which the tissue stretches abnormally. Anatomical entropion typically affects both eyes.
There are three general types of acquired, or secondary, entropion in cats.
- Spastic entropion is the most common type of entropion in cats. This type is secondary to any other painful eye (ocular) disease, such as corneal ulcers, eye pain, or dry eye, that cause involuntary ocular muscle spasms and subsequent inward rolling of the eyelid.
The eye’s anatomy is initially normal, but chronic irritation, especially from feline herpesvirus-1, causes damage that is sometimes permanent. Most often, spastic entropion involves only one eye, but it can involve both.
- Cicatricial entropion is uncommon in cats and happens when the eyelid is damaged or swollen causing an abnormal rubbing of the eye.
- Involutional entropion occurs most often in senior cats and involves the loss of the fat pad behind the eye. The loss of fat causes the eye to sink inwards and allows the lid to roll.
How Veterinarians Diagnose Entropion in Cats
Topical anesthetics: Especially with spastic entropion, numbing the surface of the eye may provide enough relief to allow the eyelid to roll back to a normal position. This is only used for diagnosis. The underlying condition must be identified to resolve the issue.
Fluorescein stain test: Veterinarians may also perform a fluorescein stain test to look for corneal ulcers. A corneal ulcer will reflect light back, and the stain makes an ulcer glow bright green under a black light.
Intraocular pressure test: The vet may also use an intraocular pressure test to look for inflammation or glaucoma as a reason for the entropion, or as a secondary side effect.
- Schirmer tear test: Veterinarians may perform a Schirmer tear test to quantify tear production. Low tear production could be the reason for pain, inflammation and irritation, leading to entropion.
Treatment of Entropion in Cats
Topical and/or oral
or injectable antibiotics
Topical and/or oral or injectable pain medications
Topical or systemic antivirals
Occasionally, cats with spastic entropion may need a temporary procedure called tacking that involves using sutures to keep the eyelid from rolling onto the eye during the healing process.
Some cats with entropion require surgical correction and typically have an excellent success rate. A veterinary surgeon removes a small elliptical wedge of skin and fur near the eyelid margin. By removing a wedge of tissue, the eyelid flips down into a normal position and no longer rolls onto the eye. Some general practitioners may feel comfortable performing this procedure, but veterinary ophthalmologists may have more experience.
Cost of Entropion Surgery for Cats
Entropion surgery may cost less than $1,000, depending on the veterinarian’s location and experience level, and if the entropion involves one or both eyes. More complicated cases and surgery done by veterinary ophthalmologists may cost several times that amount.
Hyaluronic Acid Injection
Veterinarians use Hyaluronic Acid (HA) injections as an alternative to surgery, especially in older felines that do not tolerate anesthesia well. HA is a filler-type material that allows the eyelid to be successfully turned outward. This is typically a safe and easy method in more mild cases of entropion. However, the success rate is lower - compared to surgical correction - and may require additional follow-ups and procedures.
Recovery and Management of Entropion in Cats
During the healing process, the incision area may be red and inflamed with minimal discharge. Cats will need to wear an Elizabethan collar to prevent self-traumatizing the eye or incision. Cats may recover with topical eye medications, as well as oral medications to treat pain, inflammation and to prevent infection.
Contact a veterinarian if your cat shows the following signs after surgery:
Pus-like discharge from the incision or eye
New or worsening redness or swelling around the incision and eye
New or worsening squinting
New or worsening cloudiness to the surface of the eye
Decreased or no appetite
Some cats will have permanent corneal scarring and conjunctivitis even after correction of the entropion and may require life-long medications to maintain eye comfort and health. Optixcare (eye lube plus) is a great general eye lubricating gel that helps soothe and keep the eye moist.
Brachycephalic breeds may benefit from continued lubrication and may help decrease occurrences of entropion in the future. Because most cases of entropion are spastic, it is important to monitor your cat’s eyes closely and seek veterinary treatment quickly. Early intervention offers the best chance of success and return the eye to normal function.
Entropion in Cats FAQs
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