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About Shih Tzu Eyes: Problems

In this article about Shih Tzu eyes, I describe quite a few problems but it is not meant to scare you.  The Shih Tzu is a relatively healthy breed often living to the ripe old age of 15 years old.  But like every other breed known to humans, they can suffer from some illness, some more serious than others. For more information about Shih Tzu eye care, read our article on daily care.

Please do not let the list below frighten you away from a Shih Tzu.  I have combed the internet far and wide and read every book I can get my hands on about Shih Tzu eye Problems.    The list may seem long, but chances are you will never experience most the health problems listed below. 

Any dog has the potential to develop genetic health problems just as people do.  Even with both parents free of a disease, an offspring can inherit the tendency later in life.  Many of the eye problems listed below are very common in most small breed dogs, and those breeds that have prominent eyes such as seen in the Shih Tzu Breed.

About Shih Tzu Eyes:  Eye Problems

Care for Shih Tzu Eyes

Probably the most common of all the health concerns is those associated with the eyes.  This breed like others with more pronounced, protruding eyes in relation to the skull are prone to many different problems.Some have a genetic component, but many are the result of injury or environmental assault.  The best advice anyone can give to a Shih Tzu owner is Protect those precious eyes!

About Shih Tzu Eyes Infections

The thing every Shih Tzu owner should know about Shih Tzu eyes is that they are more delicate than you think, and trauma can happen when you least expect it.  Because the Shih Tzu has large eyes and shallow eye sockets, foreign materials that fly around in the air can enter the area under his eyes, leading to inflammation and infection. Proper cleaning on a daily basis will eliminate much of the problems. 

Corneal Ulcers

The Shih Tzu's protruding eyes are not only at risk for infections and injury, but also for corneal ulcers. This condition can be caused by wind, rubbing his eyes with his paws, or any foreign object that scratches the eye. The cornea is the clear shiny membrane protecting the eye like a window. It is a rupture in the layers of the cornea that allow the eye's fluids to leak and the eye collapses. The most common cause is trauma from rubbing eyes on the carpet or other surface, a cat scratch or chemical irritation from dips and shampoo. Other causes could be bacterial and viral infections or other diseases. Treatment varies, but most ulcers can be cured in 3-5 days with medication. 


A cataract is an opaque cloudiness that affects the eye lens. Vision is affected and the effects can range from slight impairment to blindness. Cataracts are mainly hereditary, but can also be lined with old age, other retinal diseases, diabetes and trauma.  Cataracts can be treated surgically.  Cataracts are common in any breed and it is not surprising when we think about Shih Tzu eyes that this problem is high up on the list.  If untreated, cataracts will eventually cause blindness.


A Shih Tzu suffers from entropion when one or both of the eyelids turn inwards, causing his eyelashes to irritate the eye itself. It can be a congenital defect of the eyelids or be caused by injury or chronic infections.  The treatment requires surgical correction.


Epiphoria is also referred to as "wet eye," or “watery eye” or an overflow of tears or excessive tearing. This condition sometimes occurs when a dog's tear ducts do not drain correctly. This occurs because the Shih Tzu has a short face. Infections and other eye issues can also cause epiphoria. Without any other problems associated with this, it becomes mostly a cosmetic issue

Keratoconjunctivitis Sicca (Dry Eye)

Dry eye is simply a condition that occurs when there is a reduced amount of the aqueous tears are produced resulting in a dry cornea.  Tears are made up of a watery layer and a mucus layer.  When the watery portion of the tears is diminished, the mucus portion remains making it appear as if there is a thick mucus discharge, which is similar in appearance as that seen in conjunctivitis. Treatment usually involves drops and ointments, but surgery can be done.

Progressive retinal atrophy (PRA)

Progressive retinal atrophy (PRA) is an inherited disease that leads to blindness.  This condition is recognized in 86 different breeds. The disease destroys the retinal cells in the eyes leading to blindness.  There are several types including early onset slow progression, early onset rapid progression, late onset, and Sudden acquired retinal degeneration. There is no cure for PRA, but there are tests that can be done on breeding stock so they can be certified and registered as being free of PRA and are considered at low risk for carrying and transmitting the gene.

Recessive hereditary blinding disorder

This retinal disease affects the rods in the back of the eye that allow for vision in dim light. As the disease progresses, it spreads to the cones that make regular vision possible. The first signs would be that your dog has trouble seeing in the dark or nighttime.  In Shih Tzu the disease does not develop until adulthood, usually between the ages of 2-5 years. There is no cure. The result is blindness, but since blindness is not a tragedy, your dog can learn to cope and live a healthy, long life. This is very rare in the Shih Tzu Breed.


An eye condition that new owners should be aware of is Distichiasis.  More serious damage to the cornea may develop over time. Distichiasis describes a condition in which eyelashes are abnormally located in the eyelid margin. This condition may occur at any time in the life of a dog and is probably inherited in many breeds.

Clinical signs of Distichiasis include tearing (in varying amounts), redness of the conjunctiva, and inflammation and possible ulceration of the cornea. Diagnosis can be made by your veterinarian.

Treatment of Distichiasis includes epilation, electro-epilation, cyrotherapy, or surgical excision. Each procedure can offer an effective treatment regimen for canine Distichiasis.

In Shih Tzu, Distichiasis occurs with reasonable frequency and, in some dogs with shallow orbits, produces chronic inflammation of the cornea. Most dogs are only mildly affected. The hereditary basis has not been established, although it seems probable, due to the high incidence in some breeds.

About Shih Tzu Eyes:  Harderian Gland Prolapse (Cherry Eye)

In this condition, the gland of the third eyelid prolapses as a pink fleshy mass protruding over the edge of the third eyelid, between the third eyelid and the cornea.  The condition usually develops during the first year of life, but may occur later.  The cause of the prolapse is unknown but is considered to be a weakness of the connective tissue around the gland. The gland starts to move and becomes irritated. Irritation leads to swelling and discharge. The third eyelid can become bloody and ulcerated and develops conjunctivitis.  This is a common problem in other breeds as well. The treatment involves a surgical procedure where the prolapsed gland is pushed back in its pocket. This procedure can be performed under local anesthesia.


Trichiasis or Ingrown eyelashes occur when the eyelashes grow in the wrong direction.  If the lashes are soft and fine, they will probably not harm the eye, but if coarse or stiff, they can irritate the eye.  The cause may be infection, inflammation, or trauma like burn or eyelid injury. It usually happens with the upper eyelid and is treated with electrolysis, laser or other surgery; Cryosurgery is the most effective if you do not want the problem to reoccur. If untreated, these hairs could cause Corneal Ulcers.

Proptosed Globes

Our Zoey leads a perfectly normal life with only one eye.  She is a lucky dog!

I will warn you that this can be scary and I say that through experience. About the last thing I had on my mind about Shih Tzu eyes was for one of my former show dogs to loose an eye in this way!  Proptosed globes are eyes that come out of their sockets. Shih Tzu Dogs have small eye sockets and really large eyes. Any head trauma can result in the loss of an eye. The veterinarian may be able to manipulate the eye back into place, but not always.  

Approximately 40 percent of the proptosed eyes retain vision after being replaced in their globes.   Genetics play a huge part. Dogs whose eyes protrude more than others are not set in as deeply into their sockets. There is no other prevention except to keep your dog away from any dog that would induce severe fighting and do not allow them to leave your home without a leash. They should not be allowed to hang their heads out of a moving vehicle or allowed to jump from high distances.

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