Lower Eyelid Drooping in Cats

The edges of the lower eyelid gain slack in an ectropion, rolling outward and giving the eyes a “drooping” appearance. When the lower eyelid is everted, the conjunctival tissues of the eye dry out, causing a condition termed conjunctivitis. The cornea, located on the outer portions of the eye, can also try out, resulting in corneal ulcers and keratitis. The secondary conditions of an ectropion are not only painful, but can cause permanent damage such as blindness. Lower eyelid drooping in cats can become a serious condition rather quickly, which is why consultation with a veterinary professional is so important. 

When a feline’s lower eyelid appears to be drooping downward, exposing the white, delicate tissues of the eye, your cat has likely developed an ectropion. A condition commonly found in Persian cats and other short-faced breeds, an ectropion is an abnormality of the facial nerves. You may notice lower eyelid drooping affect your cat out of the blue, with no apparent cause. Most ectropions are idiopathic, or caused by unknown reasons, but others can be hereditary or a result of injury to the eyelid. All forms of ectropions allow the eye’s orbit to become exposed to outdoor elements, resulting in painful irritation to the eyeball.

The clinical symptoms of lower eyelid drooping in cats are the plainly seen, rolled out lower eyelid. Other symptoms may occur from resulting infection, dryness, and exposure to irritants, such as pollen and dirt.

• Loose lower eyelid
• Swollen eyelid
• Watery eye
• Reddened and irritated eye
• Scratching or rubbing at the affected eye
• Thick mucus discharge from corners of the eye 
• Facial staining underneath the eyes from tear pigment

Types 

Lower eyelid drooping in cats can be divided into three types; congenital, cicatricial and iatrogenic. 

• Congenital ectropion: The result of genetic abnormalities in the feline facial construction that the cat was born with.
• Cicatricial ectropion: The result of facial scarring from a wound or injury, such as a scratch from a cat fight
• Iatrogenic ectropion:  negative outcome to a surgical procedure known as a blepharoplasty. A blepharoplasty is a surgical procedure veterinarians use to alter the structure and appearance of a pet’s eyelids. A surgical procedure often used to repair ectropion cases, the opposite of ectropion (the eyelid rolls inward)
• Idiopathic ectropion: an idiopathic ectropion is when the eyelid everts itself for unknown reasons. Idiopathic ectropions are often believed to be the result of facial nerve paralysis, but the reason behind the nerve paralysis is to be determined.   

Lower eyelid drooping can either be a trait the feline was born with or one that is acquired over time. A congenital ectropion condition is present in the DNA and was passed down from generation to generation. Persian, Himalayan cats and other cat breeds bred with short faces are common ectropion candidates.  An ectropion that has been acquired over time can be the result of any of the following: 

• Facial nerve paralysis, also called Bell’s Palsy, which is a result of damage to the VII cranial nerve 
• Disease of the neuromuscular system
• Iatrogenic ectropion, a result of blepharoplasty surgery 
• Scarring of the eyelid as a result of injury 
• Hypothyroidism

Your veterinarian will be able to diagnose lower eyelid drooping in your cat through physical examination. The drooping, rolled out appearance of the lower eyelid, paired with tear staining and conjunctival irritation are clear indications of an ectropion. However, the underlying cause for the ectropion will need to be determined and the vet will evaluate the damage the eye has sustained. Common diagnostic tests your veterinarian may perform to achieve a full diagnosis include:

• A review of your feline’s medical history, including parent history, to determine a hereditary disorder.
• A fluorescein stain exam to reveal abrasions of the eye 
• Blood and urinalysis to rule out hypothyroidism in older felines  

Treatment of lower eyelid drooping is different for each affected cat. Most veterinarians will first attend to the damage the exposed eye has sustained with prescribed eye drops, ointment, and antibiotics. Your veterinarian may wish to surgically restore the eyelid to its normal position through a surgical procedure called a blepharoplasty. However, if your cat has suffered facial nerve damage, the veterinarian may decide against this surgical procedure or refer you to a veterinary ophthalmologist. 

Recovery of lower eyelid drooping in cats is fairly good, but management of the condition is often lifelong. If your cat has undergone surgery, a second or third surgery is not uncommon, as facial muscles continue to weaken over time. Eye infections, irritation, and trapped foreign objects may become a reoccurring problem for some cats too. Follow up with your veterinarian on a regular basis and select the best management plan for you as well as your cat.