Species: Canine   |   Classification: Diseases

Introduction Pathogenesis Diagnosis Treatment Outcomes Further Reading


  • Cause: macropalpebral fissure Macropalpebral fissure and a weak lateral canthal ligament.
  • Signs: the middle of the lower lid is everted (ectropion) and, in severe examples, the lateral lower and upper lids are inverted (entropion) giving rise to a 'diamond eye' configuration.
  • Diagnosis: breed, clinical signs.
  • Treatment: surgical - a modified canthoplasty.
  • Prognosis:good.

Presenting Signs

  • A 'diamond eye' configuration with more severe examples having entropion of the lateral eyelids as well as ectropion of the lower middle eyelid.
  • Those without entropion:
    • Asymptomatic.
    • Mucoid ocular discharge.
  • Conjunctival exposure and hyperemia.
  • Ocular pain (only if entropion is present).

Age Predisposition

  • 6 months-2 years old.

Breed Predisposition

Cost Considerations

  • Surgical treatment.
  • Can be difficult to manage.
    Case referral advised.



  • Congenital.
  • Macropalpebral fissure plus weak lateral canthal ligament.


  • Macropalpebral fissure Macropalpebral fissure (overlarge eyelid opening) and a weak lateral canthal ligament → laxity of the eyelids → ectropion Ectropion of the middle lower lid and in some cases, lateral entropion Entropion
  • Altered eyelid conformation → entropion → corneal irritation → corneal ulceration Ulcerative keratitis.
  • Altered eyelid conformation → lagophthalmos → exposure keratitis Keratitis.


Presenting Problems

  • Ocular pain.
  • Red eye.
  • Mucoid ocular discharge.

Client History

  • Red eye.
  • Mucoid ocular discharge.
  • Ocular pain.

Clinical Signs

  • 'Diamond eye' appearance.
  • Conjunctival hyperemia.

Differential Diagnosis


Standard Treatment

  • A Wyman canthoplasty together with wedge resections of upper and lower eyelids Eyelid: wedge resection if required. This will create a tighter lateral canthal ligament and shorten the lids.
  • A modified Khunt-Szymanowski technique in which the upper eyelid is also shortened.
  • Surgery plus treatment for keratitis/conjunctivitis.


  • Improved eyelid conformation.
  • Reduction of conjunctival hyperemia.
  • Reduction of ocular pain.



  • Good.

Expected Response to Treatment

  • Reduction of 'red eye' over 5-10 days.
  • No ocular pain.

Reasons for Treatment Failure

Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bedford P G C (1988) Conditions of the eyelids in the dog. JSAP 29 (7), 416-428 VetMedResource.
  • Wyman M (1971) Lateral canthoplasty. JAAHA 7, 196.

Other Sources of Information