"Exposure Keratopathy Syndrome in Dogs

"Exposure Keratopathy Syndrome in Dogs

Health & Safety

Exposure keratopathy syndrome or EKS, is a condition that negatively impacts the surface of a dog's eye. It is a chronic corneal disease and although it does not cause any pain and discomfort if left untreated, a dog is at risk of losing their sight. As such, as soon as the problem flares up a dog needs to be seen by a vet as soon as possible. EKS can affect any dog, although some breeds are more predisposed to developing this eye disorder than others because of the shape of their eyes and faces with brachycephalic breeds being the highest on the list.

The Causes

The condition tends to affect breeds that boast having protruding eyeballs. Dogs that suffer from lower lid entropion which is where they have a much larger than usual eyelid openings suffer from the condition because they are unable to blink as they should which helps control how much light is let into their eyes. This in turn sees an increase in tear production.

Studies have established a genetic link in certain breeds and in particular those breeds with very prominent eyes, droopy lids as well as breeds that boast having a lot of folds around their faces.

Breeds Most at Risk

The breeds most at risk of inheriting exposure keratopathy syndrome are as follows:

  • Pug
  • Pekingese
  • Boston Terrier
  • Shih Tzu
  • Lhasa Apso

As previously mentioned, breeds with more prominent eyes and abnormally large openings for their eyelids are more predisposed to inheriting the disorder.

Symptoms to Watch Out For

  • When dogs suffer from the condition, it causes a lot of pain and discomfort. Other signs of there being something wrong include the following:
  • Ulceration of the cornea
  • Reddening of the eye
  • Increased tear production
  • Pawing and scratching at an affected eye
  • Cornea turns cloudy over time

Diagnosing the Problem

A vet would ideally need to know a dog's ancestry to establish if either or both of their parents suffered from EKS. They would examine a dog's eyes to establish how badly affected they are and to confirm whether the cornea is ulcerated. Dogs with the condition tend to make their eyes sore by rubbing at them with their paws which makes their condition that much worse. The test a vet would typically recommend doing to confirm corneal ulceration is as follows:

  • A fluoroscein dye test

Treatment Options

A vet would prescribe specific eye drops that stimulate tear production and which would provide temporary relief making life more comfortable for a dog when they are suffering from exposure keratopathy syndrome. They would then recommend correcting the problem surgically if possible which they would do by reducing the size of a dog's eyelid opening. Should a dog be suffering from entropion too, a vet might have to carry out several procedures to correct the problem. If a dog's cornea is ulcerated, the vet would need to treat this too.


The only real way of reducing the risk of a dog inheriting exposure keratopathy syndrome is through careful and selective breeding. This would involve not using any dogs with the condition in a breeding programme. However, it is also important for breeders not to breed in exaggerated facial features which includes overly prominent eyes and very heavy facial folds which would put dogs more at risk of developing exposure keratopathy syndrome.

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