Breed Health Guide • Reviewed by Dr. Tiffany Delacruz, DVM
Eye Problems in Shih Tzus
Shih Tzus are predisposed to a constellation of eye conditions because of their facial conformation — protruding eyes, shallow eye sockets, and facial hair that contacts the cornea. The most common problems are corneal ulcers, dry eye (keratoconjunctivitis sicca), proptosis (eye popping out of the socket from trauma), entropion, and pigmentary keratitis.
Why Shih Tzus are predisposed to eye problems
Brachycephalic anatomy in Shih Tzus produces shallow eye sockets that don't fully protect the cornea. The eyes protrude, blink incompletely, and are mechanically vulnerable to trauma. Tear distribution is reduced because of the abnormal eyelid anatomy. Facial hair often touches the cornea. Combined, these issues mean even minor incidents — a thorn, a bath, a play scuffle — can cause significant eye injury.
What you'll see at home
- Squinting or holding one eye partially closed
- Excessive tearing or discharge
- Redness in the white of the eye
- Cloudy or hazy cornea
- Pawing at the eye
- Brown or thick discharge in the inner corner
- Visible scratches, bulges, or bumps on the eye surface
- Loss of vision — bumping into things
Red flags — go to an emergency vet
- ⚠ Eye visibly bulged out of socket (proptosis) — minutes count, drive immediately
- ⚠ Sudden severe squinting after trauma
- ⚠ Visible deep wound, perforation, or bleeding from the eye
- ⚠ Sudden complete loss of vision
- ⚠ Severe pain — yelping when blinking, refusing food
- ⚠ Cloudy or blue eye with red sclera and dilated pupil (possible glaucoma — urgent)
How vets diagnose eye problems
A vet diagnoses eye conditions with a slit lamp / ophthalmoscope exam, fluorescein staining to detect corneal ulcers, Schirmer tear test to measure tear production (for dry eye), tonometry for intraocular pressure (glaucoma), and sometimes referral to a veterinary ophthalmologist for advanced imaging or surgery.
Treatment options
Highly condition-specific. Corneal ulcers — antibiotic eye drops, sometimes pain meds, sometimes contact-lens-like collagen shields. Dry eye — cyclosporine eye drops (Optimmune) or tacrolimus drops, often lifelong, plus artificial tears. Proptosis — emergency surgery to replace the eye in the socket if possible. Entropion — surgical correction. Pigmentary keratitis — anti-inflammatory eye drops; sometimes corneal surgery.
Living with a Shih Tzu who has eye problems
- 1 Keep facial hair trimmed away from the eyes
- 2 Use saline rinses to flush debris from the eyes daily if hair is long
- 3 Avoid rough play with face contact
- 4 When grooming, take extra care around the eyes
- 5 Don't pick up a Shih Tzu by the scruff — it can pop the eye out
- 6 Don't pull a leash hard against the collar — increases pressure that can cause proptosis
- 7 Have any squinting or eye discharge evaluated within 24 hours — corneal ulcers worsen fast
- 8 Treat dry eye with consistent daily drops — skipping doses lets the cornea damage progress
Can RexVet help with this online?
RexVet is well-suited for: refills of established eye medications (cyclosporine, tacrolimus, antibiotic drops), triage of new eye redness or discharge (we'll tell you whether you need an in-person visit today or tomorrow), questions about long-term management, and follow-ups after a corneal ulcer or eye surgery.
Start a $64.99 video visit →We can't perform fluorescein staining, Schirmer tear testing, slit-lamp exams, tonometry, or eye surgery by video. Any acute eye injury — squinting after trauma, proptosis, sudden vision loss — needs in-person care immediately.
Prognosis — what to expect
Most Shih Tzu eye conditions are very manageable with prompt veterinary care. Corneal ulcers caught early heal quickly with topical antibiotics. Dry eye is lifelong but well controlled with daily drops. Proptosis is the most dramatic — outcomes depend heavily on speed of treatment and severity (some eyes are saved with full function, some lose vision, some require enucleation). Pigmentary keratitis is progressive but often slowed significantly with treatment.
Frequently asked questions
Frequently asked questions
Why does my Shih Tzu squint and tear up?
Squinting and excessive tearing in a Shih Tzu usually mean a corneal ulcer, an irritant in the eye, dry eye, or eyelid problems (entropion). All of these need a vet exam within 24 hours — corneal ulcers in particular worsen quickly and can become serious within days. Don't wait.
What does it mean if my Shih Tzu's eye pops out?
That's proptosis — the globe of the eye has come forward out of the eye socket. It's a true emergency. Drive to the nearest vet immediately. Cover the eye loosely with a clean damp cloth if it stays in place, do not push the eye back, and minimize handling. Speed is critical for any chance to save vision.
Can dry eye be cured in a Shih Tzu?
Dry eye (KCS) is rarely curable but it's very manageable. Daily cyclosporine or tacrolimus eye drops stimulate tear production in most dogs and can keep the eye healthy for years. The treatment is lifelong — stopping the drops typically lets the dry eye return. Untreated KCS leads to progressive corneal damage and vision loss.
Should I trim the hair around my Shih Tzu's eyes?
Yes — keeping facial hair from contacting the cornea reduces irritation, tear staining, and trauma. Many owners maintain a short 'puppy cut' for this reason. If you keep the show coat, daily eye hygiene (gentle wiping, hair tying back) becomes essential. Long hair touching the eye is a leading cause of preventable corneal ulcers in this breed.
Further reading from the RexVet blog
Sources
- American College of Veterinary Ophthalmologists
- Cornell — Dog Eye Conditions
- Merck Veterinary Manual — Eye and Ear
Last fact-checked: 2026-06-01. Reviewed by Dr. Tiffany Delacruz, DVM.
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