Amyloidosis, a long-term condition, is most likely related to FSF, caused by unprocessed amyloid proteins depositing in the organs, most often in the kidneys or liver, leading eventually to kidney failure. The disease is associated with the western type and it is estimated that 23% are affected. The Australian breed standard was changed in 2009 to discourage breeding for heavy wrinkling.A common problem is a painful eye condition, entropion, in which the eyelashes curl inward, irritating the eye. If untreated, it can cause blindness. In Australia, more than 8 in 10 Shar-Pei require surgery to correct eye problems, contributing to them being the most expensive breed to insure.The Shar-Pei is also prone to chronic yeast infections in its ears. This is due to a tight inner ear structure with a wrinkled appearance, making cleaning very difficult; exacerbated by the tight 'flap' that the ear creates over the canal, promoting a moist environment.Vitamin B12 deficiency is a common problem in the Shar-Pei and is suspected to be hereditary.