Eyelid agenesis in kittens: diagnosis and treatment
3-month-old domestic shorthair kitten with epiphora and blepharospasm in both eyes. The free margin of the lateral third of both upper eyelids is missing and the hair of the adjacent skin contacts the cornea, which shows keratitis with superficial vascularisation.
Which statement is correct?
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A. It is congenital entropion; it is corrected with the Hotz-Celsus procedure
There is no eyelid margin to evert: tissue is missing. Hotz-Celsus would remove even more eyelid and worsen corneal exposure.
B. It is eyelid agenesis (coloboma); it is managed with lubricants and cryoepilation in mild cases or reconstructive blepharoplasty if there is keratitis
Correct. It is the most typical congenital eyelid anomaly in cats, almost always in the lateral upper eyelid and often bilateral. With keratitis, reconstructive techniques such as lip-to-lid transposition are used.
C. It is a sequel of neonatal feline herpesvirus and is treated with topical antivirals only
The absent eyelid margin is a developmental defect, not an infectious sequel. Antivirals do not correct the trichiasis or the exposure.
D. The rest of the eye need not be examined because it is an isolated defect
Feline eyelid agenesis can be associated with other anomalies such as persistent pupillary membranes, optic nerve colobomas or retinal dysplasia: examine the whole eye.
lightbulb Key takeaway
In a kitten with keratitis and a missing lateral upper eyelid margin, think of agenesis. Small defects without keratitis can be managed with lubricants; larger ones or those with keratitis need reconstruction by an experienced surgeon.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.