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Eyes

Pug Dog Eyes

Overview

Pugs have large, gorgeous, dark eyes. Because they are so big and protrude slightly, this makes Pugs more prone to certain eye issues, though some eye problems seen with this breed are either common to small breeds or to dogs in general. Because debris can easily enter a Pug's eye and there may be issues with eye discharge, extra attention needs to be given to keep the eye area clean. 
Pug dog with big eyes
Tommy, photo courtesy of owner Srinivas
This section will cover:

Breed Standard Nomenclature Regarding the Eyes - The ideal color, shape, and expression.   
The Most Common Pug Eye Issues - This includes bloodshot and teary eyes, inflammation and irritation, dry eye, cherry eye, eyelash abnormalities, entropion, corneal abrasions and ulcers, and pigmentary keratitis (brown melanin moves onto the sclera (white) of the eye).
Pug Eye Care and Cleaning - The 5 steps to keep a Pug's eye area clean to help prevent irritation and other issues and instructions for flushing the eyes. 
Reader Q&A - Answers to commonly asked questions about Pug eyes. 

Breed Standard Nomenclature Regarding the Eyes

Breed standards are detailed descriptions of what is considered to be the 'ideal' specimen of a particular dog breed. These criterion are used when judging dogs in conformation show events and are used as a general guideline for breeders when working toward the 'betterment of the breed'. 
The AKC, along with other clubs, lists both the physical description of a Pug's eyes as well as expression: 

"The eyes are dark in color, very large, bold and prominent, globular in shape, soft and solicitous in expression, very lustrous, and, when excited, full of fire." 
The FCI standard is nearly exact:

"Dark, relatively large, round in shape, soft and solicitous in expression, very lustrous, and when excited, full of fire."

The UKC also sticks very closely to this:

"The very large, prominent, bold eyes are globular in shape. They are dark in color and very lustrous. Solicitous in expression; when excited, full of fire."  
The general consensus is that Pugs will have large, round eyes that are dark (meaning brown). Due in part to their size and shape, the eyes are vulnerable to a number of eye conditions which will be covered next. 

The Most Common Pug Dog Eye Issues

Bloodshot and/or Teary Eyes
One of the top causes of irritated eyes that are runny and/or bloodshot, and particularly when both eyes are affected in the same way, is allergies.

Allergies can be a year-round issue or appear in any of the four seasons. Though distichiasis and other conditions in this section should be ruled out, if you suspect allergies as the cause of eye irritation, you may wish to refer to Pug Dog Allergies.
Inflammation and Irritation 
Signs of this include excessive blinking or squinting, sensitivity to bright lights, discharge, dull coloring of the iris, bloodshot eyes, and/or swelling of the upper and/or lower lid. 

In most cases, this is due to small debris (a tiny blade of grass, crusted rheum - also known as 'sleep', etc.) caught in the eye.
Flushing the eyes with a canine eye rinse can usually help. If there is no improvement, the veterinarian should do an examination for underlying issues and may prescribe anti-inflammatory medication and/or antibiotics. Instructions for rinsing out a Pug's eyes is ahead under 'Pug Eye Care and Cleaning'.  
Keratoconjunctivitis Sicca 
Keratoconjunctivitis sicca, also known as dry eye, can be a very painful condition, in which there is an abrasion on the clear film that naturally protects. The Pug is very prone to this, though poor nutrition and dehydration can play a role, and it most commonly affects middle-aged and senior dogs. 

Signs of this include excessive blinking, bloodshot eyes, thick yellow discharge or pus, prominent third eyelid (nictitating membrane) showing, inflammation of the eyelids, and/or vision impairment. If not treated, scarring can occur, which can lead to complete loss of vision.

This is usually diagnosed via a Schirmer tear test that measures tear production and a fluorescein stain test to check for abrasions. Treatment includes artificial-tear medication, eye drops for lubrication, medication to reduce pain and inflammation, and in some cases, antibiotics.
Cherry Eye
Cherry eye refers to when a dog’s third eyelid (nictitating membrane; the transparent third lid that closes across the eye, rather than up and down) slips out of place and bulges out. This condition is thought to develop due to a weakening of connective tissues.

If cherry eye is not treated quickly, it can lead to other very serious issues. It is very rare for this to happen to both eyes at the same time, but once it happens to one eye it's very common for it to occur in the other within a few months.

Signs of this include a pink or red bump that significantly protrudes out over the sclera (the white part of the eye). There may also be excessive blinking or squinting, bloodshot eyes, discharge, swelling around the eye, and/or vision impairment.

This is treated with corrective surgery in which a small section of the nictitating membrane is removed and stitches are placed to secure the remaining tissue back into its proper place. Since its very common for the other eye to develop the same issue soon afterward, many veterinarians will recommend securing the other eye’s nictitating membrane in place as well, to prevent it from slipping out. 
Eyelash Abnormalities - Distichiasis and Ectopic Cilia
Both of these issues involve the abnormal growth of eyelashes. With distichiasis, a condition Pugs are moderately prone to, one or more eyelash grows in an odd direction out from the eyelid. With ectopic cilia, a condition seen less commonly with Pugs, one or more eyelash grows through the inside of the eyelid toward the eye. 

With either condition, when an eyelash pokes into the eyeball, it is extremely painful and can lead to corneal ulcers. 

Signs of this include eye pain (a Pug may paw at the eye), abnormal twitching of the eyelid, bloodshot eyes, excessive tearing, and/or change in iris pigmentation. 

Although an offending eyelash can be plucked out, offering immediate relief, it is often temporary since it usually regrows within 4 to 5 weeks. For this reason, a minor procedure is often performed to remove both the eyelash and the follicle to prevent any reoccurrence. 
Entropion
Entropion, also referred to as inverted or folded-in lid, is an inherited condition in which either the upper or lower eyelid rolls inward. This is moderately common with Pugs, usually involves the lower eyelids, and typically develops within the first year. This is mainly a genetic condition linked to tension in the ligaments of the inner eye but can also be triggered by rapid weight loss or can develop alongside chronic eye infections. 

While the inverted lid itself will irritate the eye, there are other issues that can develop. Eyelashes that that point inward can scratch the surface of the eye, leading to corneal ulcers. And, any scar tissue that may form after a scratch that can lead to vision problems or even vision loss in some cases.

Signs include excessive tearing, inflammation around the eye, and/or signs of irritation or pain. 

In very minor cases, and if the cornea is not ulcerated, the eyelid may be temporarily stitched back into place and artificial-tear medication given. However, in most cases, this needs to be resolved with corrective surgery to permanently reposition the eyelid back into position. 
Corneal Abrasions and Ulcerations
The cornea is the clear, shiny membrane that makes up the surface of the eyeball and because Pugs have very prominent eyes, corneal abrasions and ulcers are not uncommon. 

The cornea has 4 layers which are, in order of top to bottom layer, the epithelium, basement membrane, stroma, and Descemet’s membrane.
  • A corneal abrasion is a scrape that only affects the epithelium (1st layer).
  • A corneal ulcer is a scrape through the whole epithelium (1st layer) and into the basement membrane (2nd layer) or stroma (3rd layer).
  • Descemetocele is a scrape through the epithelium, basement membrane, and stroma (1st 2nd, and 3rd layers) and to the level of Descemet’s membrane (4th and deepest layer). If the Descemet’s membrane ruptures, liquid inside of the eyeball leaks out and the eye actually collapses.
The most common cause of abrasions and ulcerations is trauma to the eye which can be anything from debris entering a Pug's eye to rubbing the head along the ground resulting in a scratch. This is also linked to entropion, chronic eye infections, keratoconjunctivitis sicca (dry eye), canine diabetes, and hypothyroidism. 

Signs include moderate to severe pain (a Pug may paw at the eye or rub the eye area against surfaces), sensitivity to light, keeping the eye closed, discharge (in some cases).  

To diagnose this, the veterinarian will numb the eye, drop a fluorescein stain onto the eye, and then use a particular black light called a Wood’s light which allows abrasions and ulcerations to be visible.  

Exact treatment will depend on whether there is a corneal abrasion, ulcer, or descemetocele. 

Corneal abrasions generally are treated with topical antibiotics and often the use of a protection cone collar to prevent a dog from pawing at the eye and typically heal in 1 week or less. 

For corneal ulcers or descemetocele, treatment varies. For moderate cases, surgery may be performed to temporarily stitch the eyelid closed to allow it to heal. If both eyes are affected, each eye may be alternatingly treated. For more serious cases, other surgery including grafts or transplants may be required.  

If an ulcer does not heal as expected, there can be a buildup of dead cells on the rim of the ulcer which prevent normal cells from repairing the tear. If this happens, the dead cells are removed and surgical closing of the eyelids may follow.

Note: Sometimes, a dog will be misdiagnosed as having a minor abrasion, when it’s actually an ulcer. If there is no improvement after 2-3 days of treatment, bring your Pug back to the vet to be reexamined. 
Pigmentary Keratitis
Pigmentary keratitis refers the migration of brown (melanin) pigment from the iris into the sclera (white area of the eye). This can range from minor (which has no affect on vision) to severe (melanin covers the pupil, leading to blindness). Early detection plays a huge role in successfully managing and treating this. 

Up to 50% of Pugs have some level of pigmentary keratitis. This may develop with no underlying causes, however it is frequently linked to other issues such as entropion or keratoconjunctivitis sicca (dry eye). 

The sign of this is brown pigment seen within the sclera (white part of the eye). It can vary from faint (tiny brown specks) to severe (black patches).  

Because many cases are due to an underlying eye issue, treatment almost always involves resolving that underlying disorder. Therefore, if entropion is present, it will be treated with surgery to reposition the eyelid. If keratoconjunctivitis sicca is the culprit, it will be treated either with topical medications or, in rare cases, surgery to reposition the salivary duct. When the underlying cause is successfully treated, this will usually stop pigmentary keratitis from developing any further. 

In regard to the pigmentation that has already migrated to the cornea, there is very rarely an attempt to surgically remove it due to the risks involved, and there are no medications that have been proven to eliminate it. In time (months or even years), the pigmentation may lighten on its own. 

When caught early, prognosis is good. However, prognosis worsens the longer it takes to have this diagnosed. If the pigmentary keratitis already reached a severe level and is covering the pupil, this can profoundly affect a Pug's vision, even leading to blindness. 

Pug Eye Care and Cleaning

With such big gorgeous eyes that slightly protrude out from the face, a huge part of taking care of your Pug will be to guard the eyes against irritants, keep the eye area clean, and know how to rinse the eyes if needed. 
Daily Eye Care
Follow these 5 tips to help keep your Pug's eyes clean and protected: 

1. Take care when grooming your Pug to help prevent loose hairs, shampoo, and other grooming-related elements from entering the eyes. 
2. Routinely wipe the eye area to remove fine debris, bits of food, rheum (commonly known as 'eye sleep') and any discharge. At a minimum, this should be done once per day and ideally up to 3 times per day (after each meal). For this, use a wipe that is specifically made for the sensitive area around the eyes, it should be all-natural with no irritating additives. 
A recommended wipe to keep a Pug's eye area clean is Arava Soft & Gentle Eye Wipes. These are hypo-allergenic wipes with the all-natural soothing ingredients of chamomile and aloe vera plus lion's tooth and eyebright (made from dandelions) to keep the fur around the eyes free from staining. These work great for removing dirt, debris, eye crust and discharge. 
3. Avoid spraying cleaning products including air fresheners near your Pug and keep the house smoke-free. 
4. Have eye cleanser on hand in order to promptly flush the eyes if needed. 
5. Pay attention to your Pug's eyes and bring any issues to the attention of the veterinarian; most eye-related problems have a good prognosis when caught early. 
Removing Something from the Eye

If your Pug has something in their eye, flush this out as soon as possible. Here's how: 
What you need: A sterile canine eye cleaning solution like Tomlyn Sterile Eye Wash (this is something that owners should have on hand at all times) and clean sterile gauze.
Instructions:

1. Use your fingers to open the eye, gently pushing both upper and lower lids open wider.

2. Squeeze 4 to 5 drops into the cup of the lower lid.

3. Let go of your Pug and allow him to blink. As he does, a combination of the solution and tears will spill out from his eye. Be sure to swipe this up with a clean piece of gauze.

Reader Q&A

Can a Pug dog's eyes pop out?
It is a popular myth that this is a common occurrence. However, there is no reason why a Pug's eye would spontaneously pop or fall out. Only a very serious injury such as descemetocele (a deep cut into all layers of the cornea) could make this happen. This breed does have large, somewhat protruding eyes, however they are held into place by ligaments just as any other dog, or human for that matter. The ligaments are just as strong as with any other canine.
My Pug was just stung in the eye by a bee! It's very swollen. What should I do?
A bee sting, to any part of the body, is enough of a problem already. Canines can be allergic to the venom just as humans can. Hives and trouble breathing are just two concerns and while Benadryl can be given for minor reactions, the risk of anaphylactic shock is a concern that should be in the mind of all owners.

With a sting right to the eye, this presents a whole new set of concerns. If the bee stung your Pug directly in the eyeball, the stinger could have caused a laceration or perforating injury to the cornea which is something that needs immediate treatment at the vet's. Even if the stinger just entered into the eye area (lid, surrounding skin), severe swelling is a sign of allergic reaction. For these reasons, we'd suggest immediately contacting the veterinarian. 
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Other articles: 
Pug Feeding Guidelines - All the details you need to know about the best food for your Pug, how often to provide meals, and answers to common eating problems.  
Giving a Pug a Bath - Since this breed has sensitive skin, how you give baths and the products you use will have a big impact on skin and coat health. 
Taking Care of a Pug's Wrinkles - The facial folds on a Pug need to be kept clean and dry to help prevent common issues including irritation and skin yeast infections. 
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