Unfortunately, there are still many veterinarians who believe that ALL Chinese Shar Pei need entropian surgery. The deep-set eyes and abundance of wrinkle, especially in Shar Pei puppies, make them more prone to the condition. But tearing of the eyes is not necessarily a sign of entropian problems, as many veterinarians would lead you to believe. Chinese Shar Pei are much like humans in that their eyes can be sensitive to dust, cigarette smoke, and various types of pollen floating through the air depending on the season.  So simple tearing may be a sign of an environmental or seasonal allergy and not entropian. A bug bite near the eye or environmental allergens can also cause the eyes to swell. So it is very important that your veterinarian be knowledgeable of the Shar Pei breed and knowledgeable of what entropian is. Merely having a couple of Shar Pei clients does not mean the veterinarian has any practical knowledge of the breed.

Entropian is the rolling in of the eyelid causing the eyelashes to rub against the cornea.  Chinese Shar Pei are 1 of 14 breeds that can have this condition.  This can cause eye infections, corneal ulcers and erosions. If left untreated, permanent damage to the cornea can result in blindness.  Shar Pei puppies experiencing problems with entropian will typically refuse to open their eyes and paw or rub at them excessively. The eyelashes rubbing on the eye can be quite painful and treatment should be sought quickly.  But it is not always necessary to take your Shar Pei puppy into an emergency veterinarian service if the problem develops in the evening or weekend days when your veterinarian?s office is closed.  Most emergency veterinarian services are inexperienced with entropian, will most likely want to keep your puppy overnight, may run unnecessary expensive tests, and then simply tell you to see your regular veterinarian after handing you an enormous bill. Although your puppy will be very uncomfortable, this is not life threatening and minor abrasions to the cornea will heal.  However, this is not an excuse to let the problem persist for days before seeking treatment.

Excessive skin around the eyes is usually the cause of entropian in Chinese Shar Pei puppies. As puppies, the skin on a Shar Pei grows faster than their bodies, which gives them the typical wrinkled puppy look.  This includes the heavy wrinkling on the forehead, which can push down on the eyelids and cause the eyelids to roll inward.  But as the body and skull grows into the excessive wrinkle, the skin around the eyes stretches out. For this reason, it is typically not recommended to perform entropian surgery on Shar Pei puppies younger than 6 months of age, except in extreme circumstances.

For Shar Pei puppies, a procedure knows as "eye tacking" is performed.  Sutures are placed in the eyelid to reposition the lid margin and pull the eyelashes out and away from the eyeball.  The sutures are left in place for 10 – 14 days or longer if the suture area is not showing signs of infection.  Eye medication may also be necessary if any abrasions are present on the cornea.  If there are abrasions on the cornea that require medication, it is very important to get a non-steroid eye salve that contains antibiotics from your veterinarian.  Some Shar Pei puppies may need eye tacks more than once as they grow into their wrinkles.  Often these puppies will not require entropian surgery once they have matured and grown into their facial skin. If the eye tacks fail to train the eyelids to lie properly, then surgical correction can be performed.

Entropian surgery consists of removing a small section of the eyelid to lift the eyelashes into the proper position so they are no longer in contact with the cornea.  It is not necessary to have an "eye specialist" perform this surgery unless that is your only option.  A veterinarian who is experienced with entropian surgery is always a less expensive choice than a "specialist."  Bulldogs, Pugs, Chow Chow and Rottweilers are very prone to entropian problems, but other breeds can also be affected.  So, although the veterinarian may not be as familiar with the Shar Pei breed, he/she may have performed many entropian surgeries on other breeds.

It should be noted that although entropian problems are usually seen in Shar Pei puppies and young adult Shar Pei, this condition can occur at any time.  Older Shar Pei that have never had any eye problems can suddenly develop entropian.

Cherry Eye is the term used to describe the prolapse of the tear-producing gland of the third eyelid.  The third eyelid or "nictitans" are a thin layer of tissue located in the fold of the lower eyelid.  A normal canine eye receives tear film from two glands. One gland is located above the eye and the other gland is in the dog's third eyelid.  The tear-producing gland in the third eyelid is normally held behind the third eyelid and out of sight by a small ligament. If this gland is not strongly held in place or there is laxity of the small ligament, the gland can prolapse out of place to where it is a noticeable red mass on the inside corner of the eye. This is commonly referred to as Cherry Eye.  The size of the red mass, or Cherry Eye, can vary from dog to dog – some of them appearing quite large and partially covering the eye.  When the gland is out of its normal position, blood does not circulate properly, the gland swells and can become infected.  Initially this prolapse of the tear gland or Cherry Eye is not painful to the dog although it looks unsightly. Emergency veterinarian care is not necessary although the condition should be treated in a reasonable time frame to prevent complications.

It was once common procedure to remove the tear gland surgically once prolapse occurred. However, this was before the significance of this gland was realized.  Tear production is essential for normal health of the eyeball.  If this tear-producing gland is removed, there is only one gland remaining to provide lubrication for the eyeball.  Dry eye or keratoconjunctivitis sicca, is significantly more common is dogs when a tear producing gland is damaged or removed.  If the remaining tear producing gland cannot supply adequate tears or lubrication (very common condition in older small breeds of dogs) then treatment for dry eye must begin. It is best to maintain functioning tear-producing glands.  So treatment for Cherry Eye should consist of gently sewing the gland back in place behind the third eyelid so that normal tear production can resume. Cherry Eye is commonly seen in Bulldogs, Boston Terriers, Cocker Spaniels, Lhasa Apsos and Shih Tzu and these breeds are also predisposed to dry eye. Beagles, Bull Terriers, Bloodhounds, St Bernards, Chow Chow and Shar Pei can have an increased incidence of Cherry Eye, but are not as prone to developing the dry eye condition.  Surgically replacing the tear producing gland into its proper position is still the preferred procedure for treatment.