Contributors: Dennis E Brooks, David L Williams, James Oliver

 Species: Feline   |   Classification: Diseases

Introduction Pathogenesis Diagnosis Treatment Outcomes Further Reading


  • Entropion/agenesis/colobomaproduce irritation because eyelid hair rubs on cornea, causing serous ocular discharge, conjunctival hyperemia, corneal ulceration.
  • Ectropion- lower lid droops exposing bulbar and palpebral conjunctiva - infections and conjunctival hyperemia common.
  • Cause:
    • Entropion- anatomical (rare), spastic, post-traumatic (cicatricial).
    • Agenesis/coloboma- congenital hereditary malformation of lids, sometimes associated with optic disc and other ocular abnormalities.
    • Ectropion- anatomical (rare cf. dog), post-traumatic, neoplastic.
  • Signs: serous/purulent ocular discharge, self-trauma, conjunctival hyperemia, corneal damage.
  • Treatment: surgical repair.
  • Prognosis: generally good.
  • Some surgical repairs complicated and may require referral.

Presenting Signs

Age Predisposition

Breed Predisposition

  • Anatomical entropion seen in Persian Persian longhair especially at medial canthus.
  • Agenesis/coloboma of lids, with other ocular colobomatous defects, recorded in Snow Leopards.

Cost Considerations



  • Congenital: hereditary agenesis/coloboma, entropion (may not become clinically significant until cat reaches a few months of age).
  • Acquired: post-traumatic, neoplasia.
  • Secondary: to anterior segment pain.


  • Anatomical entropion: seen in Persians Persian longhair with shallow orbits and relatively prominent eyes, generally at medial canthus.
  • Spastic entropion: occurs secondary to anterior segment pain (corneal, anterior uvea) and globe retraction. Can be relieved with topical anesthesia if corneal pain responsible.
  • Cicatricial entropion: post-traumatic healing and fibrosis may distort lids Eyelid: laceration. Important if repairing lid lacerations to correctly appose lid margins.
  • Agenesis/coloboma: congenital lack of lid margin, forehead facial hairs impinge directly on cornea   Eyelid: coloboma or agenesis  .
  • Ectropion: rarely anatomical cf. dog, may be secondary to trauma Eyelid: laceration and aberrant healing, lid neoplasia Eyelid and conjunctiva: neoplasia distorting normal lid/globe relationship.
  • Entropion/agenesis/coloboma result in corneal damage because facial hairs abrade corneal surface (trichiasis), may cause reflex uveitis   →   secondary infection   →   progressive ulceration may   →   self-trauma.
  • Agenesis/coloboma may cause exposure keratitis even if trichiasis does not occur.
  • Ectropion exposes lower bulbar and palpebral conjunctiva   →   secondary infections more likely.
  • Epiphora Epiphora may result from inefficient blinking and tear drainage.


  • Variable.


Presenting Problems

  • Ocular discharge.
  • Red eye.

Client History

Clinical Signs

  • Facial hairs impinging on cornea (trichiasis).

Diagnostic Investigation


Differential Diagnosis

  • Important to distinguish anatomical from spastic entropion (use topical anesthesia to relieve spastic entropion).


Initial Symptomatic Treatment

  • Surgical correction:
    • Hotz-Celsus procedure for entropion.
    • Eyelid wedge resection Eyelid: wedge resection for coloboma/agenesis or for ectropion from abnormally long lower eyelid.
  • Treat underlying cause if entropion is secondary to anterior segment pain.

Subsequent Management


  • If successful, surgical correction results in complete resolution of signs.



  • Good, with adequate surgical method.
  • Consider referral.

Expected Response to Treatment

  • Facial hairs no longer impinging on cornea.
  • Ectropion: bulbar and palpebral conjunctiva no longer exposed.

Reasons for Treatment Failure

  • Poor surgery can make situation worse.
  • Topical anesthetics are used for diagnostic purposes, not therapy, as they are toxic to the corneal epithelium.

Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Glaze M B (1997) Ophthalmic disease and its management. Vet Clin North Am Small Anim Pract 27 (6), 1505-1522 PubMed.

Other sources of information

  • Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology. 2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4

Other Sources of Information