Moderate severity

Entropion (Inward-Rolling Eyelid)

An eyelid that rolls inward so the lashes and fur rub against the surface of the eye, causing constant irritation and, eventually, corneal damage.

⚠️ Common symptoms

Persistent squinting or holding one eye half-shutWatery discharge running down the faceRedness of the white of the eyePawing or rubbing at the eyeA visibly rolled-in lower or upper lid marginCloudiness or a dull patch on the cornea in longstanding cases

Entropion is a mechanical problem rather than an infection: the eyelid simply sits in the wrong position, folded inward so that the haired skin of the lid and the lashes sweep across the cornea with every blink. A cat blinks thousands of times a day, and the cumulative effect is a surface that is never allowed to heal.

The condition is far more common in dogs than cats, and when it does appear in cats it splits neatly into two groups. The first is conformational: certain breeds, particularly the brachycephalic Persian and its relatives, have skull and lid geometry that predisposes them to a lower lid that curls in from kittenhood. The second, and probably the more common presentation in general practice, is spastic entropion — a consequence of pain. A cat with a corneal ulcer or an active herpesvirus flare-up screws its eye tightly shut, and if that squint is held for long enough the lid margin inverts and begins rubbing, which causes more pain, which causes more squinting. It is a genuine vicious circle, and breaking it is the point of treatment.

Owners often describe the early stages as "a weepy eye that won't clear up". Tear staining runs down the face, the cat may be reluctant to be touched around the head, and in good light it is sometimes possible to see that the lid edge is turned under rather than sitting cleanly against the globe. Fluorescein dye applied by the vet will light up any corneal ulceration in green, confirming that the surface is being damaged.

Surgical correction is generally very successful and, once healed, permanent. The procedure is quick, done under general anaesthetic, and the sutures come out after about ten days. Cats usually need a protective collar during that period to stop them rubbing the wound. In spastic cases the vet may first use a temporary tacking suture to hold the lid outward while the underlying ulcer heals, avoiding permanent surgery in a cat whose lid anatomy is actually normal.

Left untreated, chronic entropion progresses from irritation to pigment deposition and scarring on the cornea, and in the worst cases to a deep ulcer that can perforate. It is a condition where early intervention makes an enormous difference to the eventual outcome, and where "wait and see" is rarely the right approach.

🔍 Causes

Primary (conformational) entropion is an inherited lid shape, and is seen most often in flat-faced breeds — Persians, Exotics and Himalayans — where the shortened skull and prominent facial folds pull the lid inward. Secondary entropion follows something else: chronic pain from an ulcer or herpesvirus infection makes a cat squint hard, and the sustained squint rolls the lid in (spastic entropion). Scarring from an old injury or infection can also contract the lid, and profound weight loss in elderly cats reduces the fat pad behind the eye so that the globe sinks and the lids collapse inward.

🛡 Prevention

Conformational entropion cannot be prevented in an individual cat, but responsible breeding away from extreme flat-faced conformation reduces its incidence. Treat eye infections and corneal ulcers promptly so that spastic entropion does not become established, and keep older or chronically ill cats at a healthy body weight.

💊 Treatment

Mild irritation is managed with lubricating drops and antibiotic ointment while the cause is investigated, but a lid that genuinely rolls inward will keep rubbing until the anatomy is corrected. The definitive treatment is a short surgical procedure — most commonly a Hotz-Celsus technique, in which a crescent of skin is removed just below the lid margin so that closing the wound rolls the lid back out to its normal position. Any secondary corneal ulcer is treated alongside. When entropion is secondary to painful squinting (spastic entropion) rather than lid conformation, treating the underlying eye pain may resolve it without surgery.

When to see a vet: Book an appointment for any cat that squints for more than a day, has a persistently weeping eye, or rubs repeatedly at one side of its face. Seek same-day advice if the eye looks cloudy, if there is visible blue or grey discolouration, or if your cat will not open the eye at all — these suggest a corneal ulcer that can deteriorate quickly.

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⚕️ Medical disclaimer

  • This information is educational only and is not a substitute for veterinary advice.
  • Symptoms overlap between conditions — only a vet can diagnose accurately.
  • Never withhold treatment or self-medicate based on information found online.
  • When in doubt, call your vet. Early intervention almost always leads to better outcomes.

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