tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   29 July, 2010  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
First Written: 22 January, 2002

29 July, 2010 
Be Kind To Pets
Veterinary Education
Project 2010-0129

Over the past 20 years in small animal practice, I note that many puppy owners are ignorant of the need to provide special eye care for their Shih Tzus resulting in  half blind and painful eyes for the Shih Tzus.

Therefore, I take some time to write this educational article.

As the Shih Tzu has large eyes in shallow orbits, many things and events can injure and damage the transparent cornea of the protruding eyeball.

The Shih Tzu starts to have red eyes, weepy eyes and keeps scratching his eyes. Some owners and pet shop operators selling Shih Tzus will use eye-drops to resolve the problem.

As the Shih Tzu has corneal eye ulcerations, it is impossible for the owners and unenlightened pet shop operators to cure this severe corneal ulcerations by applying eye drops of all kinds.  

Eye corneal ulcerations are emergencies. Without treatment, many dogs lose their eye-sight or their eyeball as the cornea ruptures.

In Toa Payoh Vets, the treatment of corneal ulcer includes the following:

1. The groomer clips all hairs around the eye and the facial folds.

2. The eye area and the skin is thoroughly washed.

3. The dog is given anaesthesia. The corneal ulcer is thoroughly washed.

4. An antibiotic injection is given into the subconjuctiva.

5. The eye-lids are stitched up. Eye ointment is applied daily for the next 7 days at the Surgery. I prefer the dog to be warded but for economic reasons, many owners want the dog back. 

6. After 7-10 days, the eye-lids will open up due to movement and the corneal ulcer is healed around 70%.  The dog goes home to recuperate.      

Corneal ulcers are "costly" to treat and fees from various vets are estimated to be from $500 - $1,500 depending on the severity of the condition, anaesthesia, surgery and the hospitalisation and care involved. They need to be treated within 24 hours of injury for successful outcome to save the eye sight for your dog. 


Shih Tzus are more prone to suffering from corneal ulceration. Toa Payoh VetsNo other dogs in the apartment but mynah birds do come into the kitchen. Could they be the cause of the corneal ulcer when they peck at the Shih Tzu? Or could the ulcer in the cornea be due to injuries?

A recent corneal ulcer in the right eye. Tearing and rubbing of the eye. Note that the hairs from the facial fold (raised skin fold between the eye and the nose) has hairs poking at the eye ball.

This dog could not be intubated when the endotracheal tube was inserted twice. He had a very sore throat and tonsillitis. So gas mask anaesthesia was used in order not to prolong anaesthesia which may cause death on the operating table.

The subconjunctival antibiotic injection was given. A horizontal 3/0 absorbable suture stitches up the upper and lower eyelids. Antibiotic eye ointment was applied and given daily for 5-7 days.

Shih Tzus are more prone to suffering from corneal ulceration. Toa Payoh VetsAs the dog's right eyeball is closed, the painful corneal ulcer is not irritated by the drying air and dust. The ulcer heals very well. Usually, the ulcer heals over 70% in 7 days. The stitch breaks down in 7-10 days due to eyeball motion and tension but the ulcer should heal well as it is treated early, around 2 days after failure of treatment by the owner.

For many Shih Tzu owners, money to pay for the veterinary treatment is the issue.

Therefore I don't recommend surgical removal of the facial fold. This surgery will have prevented further problems of corneal ulceration in Shih Tzus and also the Pekinese. Tarsorraphy. Eye ulcers in the Shih Tzu. Toa Payoh Vets

The facial folds have hairs growing into the eye ball and therefore causing ulcerations of the cornea. For owners who get the facial fold hairs clipped every 2 months for the rest of the dog's life, there should be no problem. But many owners have no time for regular grooming.

Eye care is especially important in the Shih Tzu if you want clear corneas and freedom of painful eyes for your pet.

A facial fold surgery may be the solution if you don't have time for regular grooming because the facial fold hairs will no longer be around. Removal of the facial fold flattens the area below the eyeball as in other breeds. So there is no more growth of hair towards the eyeball. No more irritation, rubbing and corneal ulceration for the life of the Shih Tzu --- enabling the corneal ulcer to be clear and transparent and saving the owner lots of worries, veterinary treatment and the dog lots of pain due to corneal ulceration. 

You will see many older Singapore Shih Tzus with cloudy, rough, black pigmented corneas and red blood vessels as the owners do not have time for treatment of the corneal ulcers.

The Shih Tzu rubs its eyes till the cornea becomes hardened and pigmented as a consequence of the lack of care. Some develop dry eyes as tears stop flowing. Treatment to recover a transparent cornea is too late. The dog lives with the eye pain and the dry eyes.

Maybe the best thing for a Singapore parent to do is not to buy Shih Tzu puppies for your children. Consider other breeds with no facial folds.  

Corneal ulcerations are emergencies.
Consult your vet promptly before the dog becomes blind.

2006. Health Concerns in the Shih Tzu - Dr Sing Kong Yuen

"Her left eyeball popped out after 5 pm yesterday as I saw her at that time and she was OK," lady owner said. Another dog had jumped onto this Shih Tzu. The eyeball pops out <24 hours. I could see that the dog had been rubbing eye vigorously till the upper area above the eyelid was a purplish red and the sclera (eye white) was as blood shot as it could ever be.

The beloved Shih Tzu recovered well from anaesthesia as if from a nap. I phoned the worried lady to let her know that her dog was OK.  Details are at:
Eye injuries in a Pomeranian. Eye ulcers and eyeball prolapse in the Shih Tzu.

More info at: Dogs or Cats
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Be Kind To Pets
Veterinary Education
Project 2010-0129
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