Shih Tzu Eye Problems. What You Need To Know

The Shih Tzu is prone to eye conditions because of the anatomy of their eyes and the hair that frames the face; however, some Shih Tzu eye problems are avoidable with proper genetic certification and grooming habits.


The Shih Tzu Eyes

The Shih Tzu – like many brachycephalic breeds – has naturally protruding eyes. Shih Tzu’s eyes protrude because of their skull shape and the eyes’ position.

Unfortunately, this ocular protrusion makes the Shih Tzu susceptible to eye infection, drying, and injury.


The Shih Tzu Coat

In addition to their ocular anatomy, the Shih Tzu has long hair that frames the face.

This long hair often grows over the eyes, falls into the eyes, and mats around the eyes due to tearing and eye discharge, which can cause infection and injury.


Common Shih Tzu Eye Problems

  • Cherry eye
  • Trichiasis
  • Entropion
  • Progressive retinal atrophy
  • Keratoconjunctivitis Sicca
  • Glaucoma
  • Epiphora
  • Distichiasis
  • Cataracts


Cherry Eye

Some animals have a third eyelid called a “nictating membrane” that keeps the eye moisturized and protected.

For example, in birds, the nictating membrane protects the eyeball from dust during flight without compromising their vision.

Many animals have a transparent nictating membrane, but in dogs, it is pink.

Sometimes the nictating membrane swells and pushes out of the eye, so a dog has a pink “cherry-like” lump protruding from the eye.

To treat this disorder (called “cherry eye”), a veterinarian can perform a gentle ocular massage to place the tissue back where it belongs.

The severe cherry eye requires surgical intervention, where the veterinarian attaches the gland with stitches.



Trichiasis happens when the eyelashes grow inward towards the eye instead of away from the eye.

Trichiasis irritates the eye, can cause scratches and ulcers on the eye lens, and even lead to vision loss.

Trichiasis causes eye-watering, excessive blinking, pain, discharge, and infection.

Plucking the eyelashes and antibiotic treatment provides temporary relief, but the eyelashes will grow back.



Entropion is like trichiasis in that it irritates the eye but results from the eyelid turning inward, whereas trichiasis does not affect the eyelid position.

Treatment for entropion requires surgical lifting of the eyelid to force it to roll outward in a natural position.


Progressive Retinal Atrophy

Progressive retinal atrophy, or PRA, is a genetic disorder where the retina gradually degrades. PRA can eventually cause blindness.

There is a genetic test for PRA, and owners should not breed dogs with PRA mutations.

There is no cure for progressive retinal atrophy.


Keratoconjunctivitis Sicca

Keratoconjunctivitis Sicca is also called dry eye, and this happens when the eye produces fewer tears than it should and dries out the cornea.



Glaucoma is a disease that causes eye pressure to increase because fluid cannot drain from the eye normally.

Glaucoma can occur due to anatomical abnormalities or as a result of other diseases.

Glaucoma can cause pain, vision loss, blindness, and bulging eyeballs.

Glaucoma is treatable with pain relief medications and should be monitored regularly by the vet.


Shih Tzu Eye Problem – Epiphora

Epiphora is when the eye produces too many tears or when tears do not drain from the eye properly.

This excess of tears means that the fur around the eyes is constantly wet, encourages bacteria growth, and causes staining.

Treatment for epiphora depends on the cause.



Distichiasis is a condition where extra eyelashes grow in the margin of the eyelid and rub against the eye. This irritation to the eye can cause pain, scratching of the cornea, and vision loss.

Treatment for distichiasis is surgery to remove the problem eyelashes and treat any scratching or ulceration to the eye.

To prevent the eyelashes from growing back, the veterinarian must destroy the roots of the lashes.



Cataracts give the eye a cloudy appearance over the eye lens, and they cause different degrees of vision loss. Cataracts can be hereditary, or they can result from disease or trauma.

A veterinarian can remove them surgically if cataracts cause considerable problems like severely impaired vision.


Proposed Globes

Proposed globes are eyes that are bulging out of their sockets.

Since the Shih Tzu has such small eye sockets but large eyes, the slightest trauma to the head can cause the eyes to pop from their sockets.

In some instances, veterinarians can manipulate proposed globes back into the eye socket without any permanent vision loss, but this is not always the case.

Significant trauma can cause irreparable damage to the eye, and the eyeball may need to be removed.


Corneal Ulcers

Corneal ulcers frequently happen to Shih Tzus and other dogs with protruding eyes. Ulceration can occur due to something as simple as the wind or more significant trauma.

Corneal ulcers can also be a secondary problem due to primary conditions like diabetes.

Ulceration can happen after something as simple as exposure to the wind or because of more significant trauma, for example, a dog fight.


Shih Tzu Eye Problems – Final Thoughts

The Shih Tzu is susceptible to eye infections and injury due to their eye anatomy.

Common eye problems seen in the Shih Tzu include cherry eye, trichiasis, progressive retinal atrophy, entropion, keratoconjunctivitis sicca, glaucoma, epiphora, distichiasis, and cataracts.

Genetic screening and regular grooming can help to keep the Shih Tzu’s eyes healthy but cannot prevent the possibility of all injury or infection.

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