Traumas: bites, lacerations, blows, penetrating wounds, gunshot,
scratches, kicks. Upper lid or commissure. Reparatory power of eyelid.
Danger of distortion. Treatment: sutures, plaster, shellac, collodion,
gelatine, Frick’s gelatine, birdlime, sterilisation: Quilled and
twisted suture. Position in stall. Metallic guard for eye.
_Causes._ Traumatic injuries of the eyelids are especially common in the
horse mainly because of his exposure in connection with the services
required of him. In a team he is liable to be bitten by one of his
fellows, or the lid may be caught on nails, in turning, or on hooks upon
harness, chains or wagons. It is sometimes injured by a blow from a club
or whiplash, or by knocking the head against solid objects that he
failed to see on account of the blinds. Again the injury will come from
running against prongs of bushes or trees, or of stump fences.
Occasionally a blow with the horn of an ox or cow is the cause, but this
is much more frequent with the bovine races. Then again gunshot wounds
are found in all animals. In sheep the eyelids sometimes suffer from
bites of dogs, while in dogs and cats, the teeth and claws are the main
causes of injury. These smaller animals also suffer from brutal blows
and kicks.
_Nature._ Wounds of the eyelids almost invariably affect the upper lid,
because of its extra size and prominence. Sometimes one commissure or
the lower lid is the injured part.
Clean incised wounds are rare, while lacerations with or without
contusions are the common experience. The laceration often extends
through the free margin of the lid, and then to one side, mostly the
outer, in a direction more or less parallel to the tarsus. The result is
that the detached flap drops downward exposing a greater or less portion
of the bulb covered with blood. The conjunctiva, the cornea, the
sclerotic or iris may be implicated in the lesion in different cases, so
that such wounds are of the most varied degree of gravity. If, however,
the lesion is confined to the lid, and in the absence of absolute
detachment of the flap, or severe contusion, a good repair may be
confidently hoped for. The vascularity and reparatory powers of the
eyelid are unusually great, and the looseness of the skin, connective
tissue, mucosa, and even the muscles is such that they do not draw
injuriously upon the edges of the wound to disturb the process of
cicatrization. If the two opposing ends of the divided tarsal cartilage
are kept in accurate opposition, the elasticity of his structure serves
to preserve the even contour of the palpebral margin, and the adhesion
or granulation process between the edges of the wound, soon becomes firm
enough to prevent further displacement. Even when one-half of the eyelid
is torn loose, remaining attached only by a narrow portion, reunion
without any unsightly distortion is not to be despaired of. In case of a
mere vertical laceration on the other hand, the case is very simple and
hopeful. Even when a portion of a lid has been completely torn off and
lost, the loose textures of the remaining part, often appear to stretch
in the process of healing so that a fairly serviceable, though by no
means an æsthetic covering for the eye may remain. This may serve for a
common work horse, but the unsightliness would necessarily debar him
from use in a carriage or as a saddle horse. The imperfect protection
too, exposes the eye to rainstorms, hail and snow, as well as to dust,
and greatly predisposes to conjunctivitis.
_Treatment._ One can trust implicitly to the extraordinary reparatory
power of the eyelids, yet so unsightly is any distortion of these parts,
that the greatest pains must be taken to obviate loss of substance, or
unevenness or puckering in healing. The points to be mainly sought for
are the perfect coaptation of the divided edges, and the restraining of
the patient from interrupting the healing process and breaking loose the
forming adhesions, by rubbing the eye.
Inconsiderable wounds of the skin may be simply stitched together with
sterilized catgut. Then the intervals between the stitches may be
approximated, dried, and covered with strips of sticking plaster, or
with shellac, collodion or gelatine. Frick’s gelatine is made by
dissolving fine gelatine in a 1 per cent. solution of corrosive
sublimate and adding about 10 per cent. of glycerine, perfecting the
admixture by the aid of heat. When wanted for use it may be melted by
heat and applied on the skin with a camel’s hair brush. Bird lime may be
used as a substitute. Sterilization must be sought by the use of
sublimate lotion 1:2000, or boric acid 2:100. Formerly the edges were
kept in close opposition by the use of quilled sutures, the stitches
passed around the quills being inserted at the usual distances while the
quills, applied against the edges of the wound kept them smooth and even
and obviated puckering. Or, perhaps better, the twisted suture may be
employed, the edges being brought together by pins placed close together
and a silk thread carried around each in figure of 8, and spirally from
pin to pin along the entire length. If one pin comes out it ought to be
promptly replaced and the whole left in place until a firm adhesion is
established. The points of the pins are cut off short so that there may
be no risk of their pricking.
With any method the horse or ox may be turned in his stall so that his
tail may be toward the manger and his face outward, and he may be tied
by two halters to the two posts, right and left. His food may be
furnished in a sack hung from the ceiling and cut down one side. In this
way the animal may be absolutely prevented from rubbing the itching sore
against any solid body, and thereby interrupting the healing process.
Another method is to apply a hood of stiff material with a metallic
guard for the face, having bars extending from above downward and arched
outward so that they shall effectually protect the eye in any attempt at
rubbing.