Dogs with ectropion appear to have droopy eyes, and there is visible red or pink tissue below the sclera (the whites of the eyes). Congenital ectropion is typically diagnosed before one year of age and most commonly seen in the following breeds: Basset Hound, Bloodhound, Bulldog, Cocker Spaniel, Mastiff, Newfoundland and Saint Bernard. While congenital ectropion is the most common form, some dogs may develop acquired ectropion at any age as a symptom of one of various conditions. Ectropion is not to be confused with entropion, which is the condition of the eyelid rolling inward.

Congenital
Inherited ectropion is a result of selective breeding to increase certain physical characteristics. For instance, hound breeds with excessive droopy skin are more likely to inherit a lower eyelid droop due to lack of eyelid support.

Acquired
Acquired ectropion is a symptom of one of the following conditions:

You must seek prompt diagnosis and treatment for lower eyelid droop. If treatment is delayed, corneal scarring can affect your dog’s vision and cannot be corrected. Upon physical examination of your dog, a veterinarian will be able to diagnose a lower eyelid droop easily. However, depending upon your dog’s age, further testing may be necessary. It is important that you inform your veterinarian of the onset of your dog’s symptoms in order to aid in the determination of the type and cause of the disorder. Let your veterinarian know when you first noticed the eyelid droop.

If your dog developed symptoms past the age of one year, testing will be done to determine the cause of the disorder. These tests may vary depending upon what additional symptoms your dog exhibits and what underlying cause is suspected. Basic testing to be expected is a blood sample with a blood chemistry analysis and complete blood count as well as a urinalysis. If a neuromuscular disease is suspected, a nerve biopsy may be ordered. 

If corneal ulceration is suspected, a procedure known as corneal staining involving a dye will be conducted in order to confirm ulceration. The vet should also measure tear production.

Treatment for the primary condition of lower eyelid droop will involve eye drops to lubricate the eye and ointment to prevent the drying out of the cornea and conjunctivae. Any infections will be treated with topical medicine. If the dog is rubbing, a buster collar will be used. For more severe cases, surgical correction may be required in order to provide proper support for the lower eyelid and decrease the droop.

This surgery can typically be performed by your general veterinarian, although, in some extreme cases, you may be referred to a veterinary ophthalmologist. Additionally, in cases with extreme swelling and inflammation in the area around the eye, your veterinarian or specialist may recommend separating the procedure into two surgeries in an effort to avoid overcorrection. For dogs with corneal ulcers due to infection, ophthalmic antibiotics will be prescribed first. Additional underlying causes will need further treatment, depending upon the specific cause.

With proper treatment, a dog’s chance of recovering from lower eyelid droop is very good. Surgery is typically successful; however, there is a small chance of overcorrection that can lead to further problems. If your dog’s condition is too mild to warrant surgery, medical treatment is likely to alleviate problems, although it is likely to be necessary throughout your dog’s life in order to maintain health and avoid pain. Your veterinarian may recommend an increase in the frequency of your dog’s well check ups in order to monitor the condition. In this situation, the condition may worsen as your dog enters old age, and frequency of check-ups may need to increase. If corneal scarring has occurred due to delayed treatment, your dog will have to adjust to its visual deficits.

It is important to note that if your dog has congenital ectropion, particularly if it is severe enough to warrant surgery, he or she should not be bred, as it is likely the condition will be passed on to offspring.