While ophthalmologists are known to take care of your dog or cat’s eye health, they would all agree that the eyelids are also extremely important! Eyelids and the conjunctiva lining the eyelids play a major role in corneal and globe health. As the eyelids are covered in skin, they are susceptible to the same diseases and conditions that can affect a dog’s skin over their body. When your ophthalmologist develops a therapy plan to treat eyelid inflammation in your dog or cat, your pet’s level of discomfort and the best route for medication administration are considered. Eyelids are a highly vascular and highly innervated tissue, so they can become inflamed quickly when there is some insult, and they can become pruritic (itchy) and uncomfortable when inflamed. Eyelids protect the eye by acting as a shield, but also contain glands which are necessary to produce part of the tear film which in part keeps the cornea healthy.
Clinical signs of blepharitis include increased redness, edema and swelling of lids. Dogs may squint, produce more tears and rub at their eyes. If dogs rub at their eyes excessively, hair loss, wounds and scale can occur. If inflammation of the eyelids is left untreated, the lids can become thickened and scarred and chronic inflammation can lead to a qualitative tear deficiency (a certain type of dry eye). If identified early, many dogs can do well with medical management of their eyelid inflammation depending on the cause of their underlying cause.
There are many possible causes for blepharitis including immune-mediated conditions, bacterial infections, skin parasites, inflammation of the meibomian glands, and allergic disease. Young dogs can develop a bacterial overgrowth involving their lids called purulent blepharitis which most often involves Staphylocci
bacteria which normally inhabit the skin. Adult dogs can develop bacterial blepharitis if they are immunocompromised, or most often, as a secondary infection to inflammation and irritation that is already
present. Dogs affected by parasites such as Demodex and Sarcoptes (scabies) can also develop inflammation of their eyelids. A thorough history and skin sample may be required to make this diagnosis.
Immune-mediated conditions which affect the skin can also affect the eyelids including Pemphigus, uveodermatological syndrome in Akitas and other breeds, and other generalized immune-mediated blepharitis. Inflammation of the meibomian glands which line the eyelids are common and can cause Chalazion (non-painful swelling of a gland), stye or meibomianitis (painful swelling of the glands). Allergic
blepharitis can occur if a dog is sensitive to an ingredient in an eye medication (contact allergen) and less commonly can occur due to seasonal or non-seasonal environmental allergens.
Depending on the suspected cause for blepharitis, a combination of antibiotics and corticosteroids is most often recommended by the ophthalmologist. Oral antibiotics such as Clavamox (clavulanate and amoxicillin), doxycycline or cephalexin are used to treat a primary or secondary bacterial infection of the eyelids. Oral corticosteroids such as prednisone or prednisolone are used to help treat the active inflammation of the eyelids and will help with discomfort as well. Topical antibiotics or lubricants may be used to provide extra protection for the cornea. Additional topical treatments may be used if the cornea is affected due to eyelid inflammation. Depending on the appearance of
a patient’s eyelids during their eye exam, warm compresses at home may provide additional comfort and help relieve some swelling of the eyelids as well.