Exposure Keratopathy Syndrome is a corneal disease that results in brown pigmentation that “grows” across the cornea. This is often concomitant with scar tissue formation and blood vessel infiltration.

We commonly see this condition in brachycephalic (or “short nosed”) breeds such as Pugs, Pekingese, Boston Terriers, Shih Tzus and Lhasa Apsos. These breeds exhibit prominent eyes and have abnormally large eyelid openings.  This results in marked exposure of the cornea and can lead to a decreased ability to blink normally and rapid tear evaporation (rapid tear breakup time), both of which can aggravate EKS. It is important to remember that it is usually a non-painful syndrome, but if left untreated, may result in a marked loss of vision.  Therefore, early diagnosis and treatment is important. Your pet will likely need ongoing topical medical therapy to help prevent the pigmentation from worsening.


1) Labelle A., Dresser C., Hamor R., et. al. Characteristics of, prevalence of, and risk factors for corneal pigmentation (pigmentary keratopathy) in Pugs. Journal of the American Veterinary Medical Association 2013; 243: 667-674.