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Most people think of droopy eyes in a dog as sagging underneath the eye, where the lower eyelid is rather prominent, and sags away from the eye itself. Because the lower eyelids droop, the dog’s tears often drain onto its face, bypassing the normal route through the tear ducts to the nose. This can cause staining of the dog’s face. However, a dog’s upper eyelids can also droop, in which case the dog’s pupil is constricted, the eye appears to be recessed into the dog’s head, and the third eyelid of the affected eye can appear to be reddened and higher in the eye than usual.
Droopy eyes are normal for some dogs, in which case there is no cause for concern. However, if the drooping, on either the upper or lower eyelids, is beyond the normal range, or is abnormal for your dog’s breed, there may be a serious problem. Eyes are one of the most delicate parts of the body, and should be carefully monitored.
Medical issues related to a dog’s droopy eyes are due to either structural issues with the dog’s eyes, as in the cases of ectropion and cherry eye, or external irritants or damage, as in the cases of conjunctivitis and Horner’s syndrome.
Ectropion and cherry eye are both conditions which can occur without any apparent external causes. A dog with ectropion will have a lower eyelid that droops far enough down from the eye that the tissue of his inner eye lid is exposed, making it vulnerable to injury and irritation. Many hounds inherit this condition, though it can also be caused by paralysis of the connected facial nerve, hypothyroidism, or neuromuscular disease. Because it is usually congenital, ectropion will usually be diagnosed before the dog is a year old. Congenitally droopy-eyed breeds that are vulnerable to ectropion include the Basset Hound, Bloodhound, Bulldog, Cocker Spaniel, Mastiff, Newfoundland, and Saint Bernard.
Dogs with wide flat faces, such as Lhasa Apsos, Shih Tzus, and Boston Terriers, have a genetic predisposition to cherry eye, a condition in which the third eyelid’s tear gland expands, protrudes from the eye, and becomes red. As the tear gland is then unusually exposed, it is subject to irritation, and can become painfully inflamed.
A dog whose eye gets irritated or infected from external sources, such as bacteria, a virus, dust, or allergens, can easily develop conjunctivitis, or pink eye. The conjunctiva is the membrane that protects the dog’s eye; conjunctivitis refers to the infection of this membrane. Viral and bacterial conjunctivitis are especially contagious. Any dog can easily contract conjunctivitis. The conjunctiva membrane is, after all, the eye’s first line of defense, and comes into contact with many different substances.
Horner’s syndrome, which disproportionately affects Golden Retrievers and Cocker Spaniels, is a disruption of the nerves that control parts of your dog’s eye. This is always caused by a lesion (central, preganglionic, or postganglionic) that damages the nerves somewhere between the brain and the eye. The damage can result in a droopy eyelid, constricted pupil, sunken eye, elevated third eyelid, and impaired vision.
Some causes of droopy eyes require minimal treatment, while others require interventions as serious as surgery. Horner’s syndrome commonly disappears on its own. Conjunctivitis is treated topically, with antibiotic creams and eye drops, though if caused by a physical defect, may require surgery. Mild cases of ectropion can be treated with eye drops and ointment for lubrication, but more serious cases will require surgery to make the eyes less droopy. If treated early, cherry eye can successfully resolve with only the use of anti-inflammatories and ligament-strengthening medications, but if not, surgery will be necessary.
To prevent conjunctivitis, take care to keep your dog’s eyes clean, and keep him away from any dogs who might be infected. It is usually not possible to prevent ectropion, as it is largely a congenital condition. Taking the long view, a breeder would want to breed excessively droopy eyes out of their line of dogs. The causes of cherry eye and Horner’s syndrome are often unknown, thus are not preventable, but keeping your dog safe from head trauma can prevent any trauma-related nerve damage.
The cost of treating your dog’s droopy eye varies, but averages in a range under $1000. Conjunctivitis costs an average of $500 to treat; ectropion and cherry eye each cost an average of $600 to treat; and Horner’s syndrome is the most expensive, costing an average of $850 to treat.
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