Exposure Keratopathy in Dogs

Treatments need to begin quickly to keep your dog from losing their sight. Any dog can be affected by exposure keratopathy syndrome but there are certain breeds that are predisposed to developing EKS. Brachycephalic breeds are the most likely to develop EKS because of the shape of their faces and eyes. 

Your veterinarian may be able to diagnose and treat exposure keratopathy syndrome in your dog, but they may also be more comfortable referring you to an eye specialist for the proper diagnosis and treatment. If your veterinarian refers you to a canine ophthalmologist, be sure to make an appointment as soon as possible to begin treatments.

Exposure keratopathy syndrome, or EKS, in dogs is a medical condition that will negatively impact the surface of your dog’s eye. It can cause discomfort or pain to your dog and it is a chronic corneal disease that can cause your dog to go blind. EKS includes exophthalmos, lagophthalmos and macroblepharon, all are ocular diseases that are known to be genetic.

When you notice any changes to your dog’s eyes, you should make an appointment with your veterinarian for an assessment. Your dog’s sight may rely on a quick diagnosis and treatment. Symptoms of exposure keratopathy syndrome to watch for include:

• Ulceration of the cornea
• Reddening of the eye
• Rubbing or scratching at the eye
• Increased tear production
• Cloudy cornea
• Blindness in one or both eyes

Researchers have discovered a genetic link in certain breeds, especially those that have very prominent or protruding eyeballs, droopy eyelids and/or a lot of wrinkles or skin folds on their face. Dogs that also suffer from lower eyelid entropies are also at risk because they have trouble blinking, which will control how much light is let into their eyes. Tear production is increased.  Responsible breeders will not breed dogs that have developed EKS or have especially elongated facial features or exaggerated, protruding eyes.

Brachycephalic breeds are the most at risk of developing or inheriting EKS and of those breeds the Pug, Pekingese, Boston Terrier, Shih Tzu and Lhasa Apso are the most likely to be diagnosed with it.

Your veterinarian will begin by conducting a physical examination on your dog and trying to establish a medical history as well as a genetic history. If one or both parents have suffered from exposure keratopathy syndrome, be sure to tell your veterinarian as this will help with the diagnosis of your dog. 

Your veterinarian will do an examination of your dog’s eyes to see how badly they are affected and also to confirm if the cornea has been ulcerated. If your dog has been rubbing or scratching at their eyes, they can make the condition much worse. Be sure to tell your veterinarian if your dog has been rubbing or scratching. 

A fluorescein dye test can be conducted to confirm a corneal ulceration. During a fluorescein dye test, dark orange dye is placed onto the outer surface of your dog’s affected eye. A blue light is then shined in the eye. If there are any problems such as an ulcerated cornea, the problem area will turn green under the blue light. Your veterinarian may refer you to a canine ophthalmologist for a fluorescein dye test, proper diagnosis and treatment of EKS.

Your veterinarian may decide to refer you to a canine ophthalmologist for more specialized care. Medicated eye drops may be used to help stimulate tear production and provide relief of any dry eye that your dog may be experiencing. 

Many times, surgery will be necessary to correct the problem. This is done under general anesthetic. Your veterinarian will then reduce the size of your dog’s eyelid opening. It may take several surgeries to fully correct exposure keratopathy syndrome depending on how severe the problem is with the eyelid. If your dog’s cornea has been ulcerated, your veterinarian will prescribe medicated eye drops to treat the ulceration.

Your veterinarian will give you specific instructions on post-surgical care for your dog. Keeping them from rubbing the affected eye will be important to help promote healing. Be sure to follow your veterinarian’s instructions carefully and give any medication as prescribed.

Since there is a genetic link to exposure keratopathy syndrome, the only way to prevent it from occurring is to practice selective breeding. Responsible breeders will not knowingly breed a dog that is genetically predisposed to develop EKS. Eventually, EKS can be eradicated from a bloodline by selective breeding.