Problems affecting the eyelids may be congenital (present at birth) or may occur as a result of injury, infection, disease of the surrounding skin, body-wide diseases, or exposure to various types of irritants.
Entropion is the turning in of the edges of the eyelid so that the eyelashes rub against the eye surface. It occurs more often in Persian cats and other breeds with shortened, flattened heads. It can also occur because of scarring of the eyelids or because of excessive blinking due to pain in the eye or the surrounding area. The turning in of eyelashes or facial hairs causes discomfort and irritation of the conjunctiva and cornea. Long-lasting entropion can cause scarring, abnormal coloring, and possibly the formation of slow-healing sores on the cornea.
Early spasms of entropion may be reversed if the cause is removed or if pain is lessened. Turning the lid hairs back away from the eye with stitches in the lid, injections of medication into the lid close to the area where the lid is turning in, or using anesthetics to block the nerves in the eyelids are some of the methods that have been used to treat early entropion. Established entropion usually requires surgery to correct the defect.
Ectropion is a slack eyelid edge that is turned out, usually with a large notch in the eyelid. Scars in the eyelid or facial nerve paralysis may produce ectropion in one eyelid. Exposure of the conjunctiva to environmental irritants and secondary bacterial infection can result in longterm or recurrent conjunctivitis (inflammation of the conjunctiva). Topical antibiotics may temporarily control infections, but surgical lid-shortening procedures are often necessary to resolve the condition. Repeated, periodic cleansing of the affected eyelid with mild decongestant solutions can control mild cases. To protect your pet’s eyesight, follow your veterinarian’s treatment program carefully.
Lagophthalmos is an inability to fully close the lids and protect the cornea from drying and trauma. It may result from extremely shallow orbits, a common condition in breeds with short, broad, flattened heads (such as Persians). Scarring, abnormal coloring, and the formation of slow-healing sores of the cornea are common problems with this condition. Unless the cause can be corrected, treatment involves frequent use of lubricating ointments and surgical shortening or closure of the corners of the eye either temporarily or permanently. Excessive nasal skin folds and facial hair may aggravate the damage caused by lagophthalmos.
Abnormalities of the eyelashes include extra eyelashes or misdirected eyelashes on the lid edge. These abnormalities are rare in cats. When present, they may cause watering eyes, development of blood vessels in the cornea, and slow-healing sores and scarring in the cornea. In many instances, irregular eyelashes are very fine and do not cause signs of irritation or damage the eye. However, eyelashes that point backward toward the eye can cause profound pain. If the extra lashes cause damage to the cornea or conjunctiva, it may be necessary to surgically cut out or freeze and remove the eyelash follicles.
Occasionally kittens are born with a developmental deformity of the upper eyelid called a coloboma, which appears as a cleft in the eyelid. The defective eyelid is often unable to function properly, leaving the eye exposed and at risk for inflammation and the development of ulcers unless it is surgically repaired.
Inflammation of the eyelids (called blepharitis) can result from the spreading of a generalized inflammation of the skin, inflammation of the conjunctiva, local glandular infections, or irritants such as plant oils or sunlight. Fungi, mites, or bacteria can infect the eyelids, which can then lead to a generalized inflammation.
Lesions of immune-mediated diseases can occur where the skin and conjunctiva join. Pemphigus is an example of a disease in which large blisters occur on the skin and mucous membranes. Pemphigus is often accompanied by itching or burning sensations. Skin scrapings, cultures, and biopsies may be required for an accurate diagnosis. Localized glandular infections may be short-term (for example, a stye) or longterm (for example, a Meibomian abscess).
When inflammation of the eyelids is caused by a generalized condition, whole-body therapy often is necessary in addition to treatment of the eye itself. Supportive therapy of hot packing and frequent cleansing with a warm washcloth is often used in severe cases. Your veterinarian will recommend a treatment program designed to control the generalized condition, make your pet more comfortable, and treat the eye condition. Be sure you thoroughly understand the treatment program your veterinarian recommends. Do not hesitate to ask for detailed instructions regarding any eye drops or other medication you will need to provide for your pet. It is often helpful to have the veterinarian demonstrate the administration of these medications.
Also see professional content regarding disorders of the eyelids.