Shih Tzu Eye Problems: A Comprehensive Guide for Concerned Owners 2026

As a veterinarian, probably the number one problem that I am hearing from Shih Tzu owners involves eyes. And given that this is one of the most common complaints owners make, it doesn’t seem to be a coincidence that this breed seems to be pre-disposed for nearly any and all ophthalmic conditions-in one study, a record breaking 96.4% of Shih Tzus demonstrated ocular abnormalities in their examination! The point isn’t necessarily to make owners nervous or concerned, but to stress the fact that owner attention is particularly key for this breed.

The cause of many these problems is related to the endearing brachycephalic, or ‘squishy-faced’ body build.

Shih Tzus have very shallow orbits and shallow eye cavities so their eyes protrude from the orbit even more than normal. They also tend not to blink correctly, and because of this, their eyes are much more exposed to all sorts of irritants than the typical dog’s.

Why Shih Tzus Are Prone to Eye Issues

Structure leads to a condition known as Brachycephalic Ocular Syndrome. Such a state incorporates:

• Exposure: Their eyes are further forward (exophthalmos) their lids are not able to completely cover the eye at the time of blinking (lagophthalmos). Their eyes are therefore extremely prone to drying out.
• Friction: The hairs around the eyes are turned inward (trichiasis) as are sometimes their eye-lids themselves (entriopn). This means that hair frequently causes constant irritation to the eye itself.
• Tear quality is frequently very poor (even if amounts of tear are not). This can mean that the tears evaporate very quickly, giving similar signs of irritation and drying as can not closing lids does.

An eye of a Shih Tzu is therefore a very delicate organ and must be observed every day and visited by a vet from time to time.

Also Check: How to Encourage a Cat With Kidney Issues to Drink Water Naturally 2026

The 6 Most Common Eye Problems in Shih Tzus

Here are the conditions we see most frequently in practice.

1. Keratoconjunctivitis Sicca (KCS) or “Dry Eye”

Dry Eye: This is extremely prevalent in Shih Tzus, likely as an immune mediate disease where the immune system is attacking the tear producing glands. When there isn’t enough tears on the cornea the cornea dries out and the cornea inflames; and the cornea becomes susceptible to damage. We can see a thick mucoid discharge (often greenish yellow), redness and an opaque dull appearance of the cornea.

Treatment: Standard is the immuno suppressive medications, such as cyclosporine (Optimmune) or tacrolimus eye drops. They are not like artificial tears but work to boost the natural tear production on the eye. Artificial tears are often used to supplement the above therapy, but will not cure the problem. Usually, this medication will need to be used life long.

2. Corneal Ulcers

In essence, the corneal ulcer is simply a scratch/erosion of the clear surface on the front of the eye. Because the eyes stick out the owners of Shih Tzu’s are very prone to corneal ulcers that either occur through trauma, dry eye, or hair irritating the surface of the cornea. Signs that an eye has an ulcer aresquinting (blepharospasm), excessive eye watering, red eye, and a cloudy looking eye.

Treatment: This is an emergency! NEVER leave ulcers unattended in Shih Tzu’s. A vet will use a special dye called fluorecein to diagnose a scratch to check if an ulcer is present, and treat the animal with antibiotic drops and pain medication. If treatment is delayed, the ulcer can dig deeper and even perforate ( poke through) the eye causing the animal to require surgery (like a conjunctival graft) on its eye that would be astronomically expensive.

3. Pigmentary Keratitis

This happens when over time the mild irritation of a condition such as dry eye or an inwardly turned lid causes melanin pigment to darken the surface of the normally clear cornea of the eye. You’ll see a dark brown or black pigment that tends to spread across the eye. It is not inherently painful but indicates a chronic inflammatory process and if it is widespread and covers the pupil it can cause loss of sight.

Treatment of pigmentary keratitis: Since the root of the problem is a condition causing excessive irritation of the eye, treatment is primarily focused on resolving the underlying inflammation, dry eye and/or entropion/trichiasis. Your veterinarian will prescribe an anti-inflammatory eye drop to try and arrest and even sometimes reverse the pigment deposition, although completely eliminating it often poses a challenge. It is infinitely preferable to prevent the problem from developing in the first place.

4. Eyelid and Eyelash Abnormalities

The anatomy of a Shih Tzu’s face often leads to problems with the eyelids and eyelashes. Ten Leads to eyelid and lash irritation.

• Entropion: The eyelid rolls in on itself and the lashes scrape on the eye. This is common cause of corneal ulcer.
• Trichiasis: A hair growing from normal location(such as the inside of the corner of eye)which is in contact with the cornea.
• Distichiasis: An additional row of eyelashes grows from the eyelid border and comes in contact with the globe.

Treatment: In some mild case lubricant can be given, otherwise, the eyelids may be operated on to keep them on proper position and remove these hairs.

5. Cherry Eye

A condition in which the third eyelid gland,located in the corner of the eye,prolapses (falls out). It appears as round, red,cherry shaped mass. It does not typically cause discomfort,but can result in dry eye later in life as this gland is a major part of the tear film.

Treatment: The only treatment is surgery to “tack” the gland back into it’s normal anatomy and location to keep it from interfering with tear production.

6. Cataracts

Cataracts These are seen with age in Shih Tzus and cloud vision because the eye’s lens becomes opaque ( cloudy or white). They are largely inherited.

Treatment: There is no other Treatment other than surgical removal of the cataract that can bring the vision back, this should ideally be done by a board certified veterinary ophthalmologist.

Emergency Signs: When to Rush to the Vet

For the Shih Tzu breed of dog, there’s one thing to beware: Eye issues can rapidly and severely affect a Shih Tzu. Seek veterinary help immediately if your Shih Tzu presents any of these issues:

• Eye Proptosis: Your Shih Tzu’s eye may prolapse, or in other words bulge, from it’s socket. This is a serious emergency to the eye and must not be manually pushed back into the socket. Place a cool compress over it and take your Shih Tzu to the veterinarian immediately.
• Widespread Eye Cloudiness: Eye is suddenly opaque-white.
• Immediate Blindness: It seems like your Shih Tzu is running into furniture.
• Deep Wound or Blood in Eye: Visible damage and trauma to the eye.

However, even if your Shih Tzu seems to be just blinking excessively or pawing at their eye, even if it doesn’t appear severely damaged; it can be serious and warrant attention to their vet.

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