We just got back from the longest vet visit ever. He has an auto immune disorder called kcs it destroyed his tear ducts and made his tear production 0. It also caused scaring which has severly affected his vision in his right eye. His left eye isnt as bad bu has mild distichia. The good news Is no entropian they dont believe. Just swelling from the other issues. He also has a double ear infection and a skin infection which they think might be staff.also we are waiting for allergy test results. He does not need surgery just drops for the rest of his life. We left the vet with 3 antibiotics ear meds eye ointment and are waiting for another eye med from a compounding pharmacy to come in the mail. He is also ten pounds over weight. Hopefully soon my puppy will be right as rain and much more comfortable.