Eyelid Reconstruction in Dogs

The eyelids protect the eyes from trauma and shield them from debris. Certain conditions affecting the eyelids may warrant eyelid reconstruction. This is typically performed on the upper eyelid. Domestic animals with normal upper eyelids may not require eyelid reconstruction. However, constant eye watering and conjunctiva irritation often occur in animals with deformed or diseased lower eyelids.

Any condition that detracts from the function of the upper eyelid will require eyelid reconstruction. Missing and diseased portions of the upper eyelid will cause the cornea to dry out, which may present more severe complications. Minor eyelid reconstruction procedures may be performed by a veterinary surgeon. A veterinary ophthalmologist will need to treat more complex cases.

The specific procedure steps will vary based on the underlying condition. Large defects will require plastic surgery.

1. Blood work will be taken prior to surgery to ensure it is safe to administer general anesthesia.
2. General anesthesia and analgesics are administered intravenously prior to intubation.
3. The eyelid is carefully cleaned and prepped for surgery.
4. Any tumors located on the eyelid are excised, along with up to one-third of the eyelid tissue.
5. The ophthalmologist will choose a site for a skin graft sample. This may be taken from a normal eyelid, or from the cheek or lip.
6. A flap outline is made before skin grafting begins.
7. The skin graft is sutured to the site.
8. The dog will be hospitalized for forty-eight hours after surgery, or according to the ophthalmologist’s recommendation.
9. The removed eyelid portion will be sent to a veterinary histopathologist for examination.

Eyelid reconstruction, though invasive, is often effective for treating eyelid conditions. It does not typically present any postoperative complications. In most dogs, the skin graft is successful, and the appearance of the eyelid is normal after six weeks. However, healing times may vary based on the severity of the condition and the extent of surgery.

Dogs recovering from this procedure will need to wear an Elizabethan collar until the sutures are removed within fourteen days. Triple-strength antibiotic ointment is prescribed to ward off postoperative infection and rid the eyelid of bacteria. Analgesics may be prescribed for pain. On the return home, you should check the suture site daily to ensure bleeding or drainage does not occur. Swelling of the eyelid is normal for the first few days after surgery. Monitor your dog’s blink reflex, and note any abnormal discharge or eye watering. If you notice any signs of postoperative complications, contact your veterinary ophthalmologist immediately.

The cost of eyelid reconstruction will vary based on the severity of the condition, as well as standards of living and additional costs incurred. The price of eyelid reconstruction ranges from $800 to $3,000. These figures may or may not include the cost of hospitalization, medication, anesthetization, and diagnostic tests.

Complications associated with eyelid reconstruction do not typically occur. Complications of eyelid reconstruction include, but may not be limited to:

• Infection and wound rupture due to irritation of the sutures
• Skin graft failure
• Impeded eyelid movement
• Abnormal blink reflex

It is imperative that dogs wear the Elizabethan collar until the sutures are removed. Wound rupture may warrant a second corrective surgery. The veterinary ophthalmologist will discuss all possible complications with you, as well as alternative forms of treatment, prior to surgery.

Eyelid reconstruction is an expensive, complex, invasive procedure. For benign tumors that do not cause any symptoms or detract from eyelid function, this procedure is purely cosmetic. You should consult a veterinary ophthalmologist to ensure this procedure is right for your dog.

Certain conditions affecting the eyelids, particularly cancer, are difficult to prevent. Activities which may cause trauma to the eyelids should be avoided. Poisons and toxic substances should be kept out of reach of pets at all times. Dogs treated for genetic conditions should not be bred.