Combined Entropion and Ectropion

The combined occurrence of entropion and ectropion in the same eye gives the palpebral fissure a diamond-shaped appearance, hence the term "diamond eye." This specific eyelid conformation occurs when lateral and medial entropion affects the upper and/or lower eyelids while ectropion is present centrally. It is characteristic of certain large dog breeds with wrinkled facial skin, including the Bloodhound, English Mastiff, and Bullmastiff. Clinical signs may reflect both ectropion and entropion and include trichiasis, keratitis, conjunctivitis, and corneal ulcers.

Treatment

Most dogs have no clinical problems. If clinical signs develop and cannot be controlled with medical therapy, surgical treatment is performed, but only after the dog has reached full physical maturity. In young dogs, temporary correction can be achieved with everting sutures. Surgical correction generally requires more complex oculoplastic procedures and should be performed by a trained specialist with appropriate experience in the surgical management of these patients. Simple eyelid-eversion procedures have a high failure rate in controlling this condition.

Dogue de Bordeaux with medial and lateral entropion and central ectropion of the lower eyelid. The upper eyelid has medial entropion. Trichiasis is present on the upper eyelid.

The dog from the previous figure, both eyes.

Adapted from the Atlas of Ocular Diseases in Dogs and Cats by Dr. Siniša D. Grozdanić and colleagues. © Animal Eye Consultants of Iowa. The text and clinical images on this page are original content from the authors' own clinical practice and research, and may not be reproduced, distributed, or repurposed without permission.

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