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Brachycephalic ocular syndrome

02 October 2020

Clinical

13 mins read

02 October 2020

Volume 11 · Issue 8

ISSN (print): 2044-0065

ISSN (online): 2052-2959

Figure 1 A macropalpebral fissue with a large area of medial scleral exposure and medial trichiasis as a result of entropion.

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Abstract

The small brachycephalic breeds such as the Pug and French Bulldog are currently extremely popular. The conformation of these breeds is part of their appeal to owners, however it leads to ocular surface disease such as corneal ulceration and pigmentation. The eye problems associated with these breeds are collectively known as brachycephalic ocular syndrome. In the normal situation there is a close interaction between the tear film, the eyelids and the cornea, which in the affected breeds is disrupted. Treatment needs to address the causes of the problem, such as lid anatomy, as well as the resultant corneal disease. Combinations of both medical and surgical treatment are required. Hospitalisation and anaesthesia of these cases requires careful, gentle handling and caution to prevent respiratory distress and damage to their often fragile eyes.

Small brachycephalic breeds are especially popular currently. Based on Kennel Club figures, in the 10 years between 2010 and 2019 there was a significant increase in Kennel Club registrations, with a 1527% increase in French Bulldog registrations (Kennel Club, 2020).

The neonatal appearance of the breeds (enlarged forehead, eyes, and head size relative to the trunk) may be at least part of the reason these dogs are found attractive (Sternglanz et al, 1977; Packer et al, 2017). Facial morphology may increase the frequency of eye disorders (Packer et al, 2015a), and ophthalmological disease is the most prevalent group-level disease in Pugs (16.25% prevalence) with corneal disorder being the second most prevalent diagnosis-level disorder (8.72%) after obesity (O‘Neill et al, 2016).

The term brachycephalic ocular syndrome (BOS) is used to describe the eye problems, associated with conformation (exophthalmia, shallow orbit, lagophthalmia, euryblepharon, trichiasis, medial lower lid entropion, exoptropia and involution of the medial canthus) in small brachycephalic breeds such as the Pug or French bulldog. These dogs often present with poor corneal health and poor-quality tear films (Carrington et al. 1989; Krohne, 2008; Stades and Van Der Woerdt, 2013) (Figure 1).

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