In foals, puppies, hounds, with narrow fissure, and conjunctivitis, or
tarsitis. Permanent bandaging, orbicularis spasm. Symptoms:
disappearance of tarsus and lashes by involution. Treatment: in spasm
fix by plaster; suture skin; excise elliptical section of skin and
suture edges together. Release cicatrices.
Inversion of the eyelid or a portion of it, with consequent trichiasis,
conjunctivitis and lachrymation has been met with congenitally in foals
(Aubry, Bourdeau, Hamon) and puppies (Cadiot, Almy). Hounds have
especially suffered. In the older animals it is largely determined by
abnormally narrow fissure, and by old standing disease of the
conjunctiva or tarsus, with cicatricial contraction or adhesion.
Persistent bandaging turns in the cilia and contributes to entropion.
Finally a persistent spasm of the orbicularis muscle may bring it about.
_Symptoms._ Trichiasis is usually, though not always, present.
In any case the tarsus is turned inward so as to press upon the front of
the bulb, or even to disappear completely. Thickening and distortion of
the lid is a not infrequent condition.
_Treatment._ In case of simple spasm clip or shave the hairs from the
lid corresponding to the lesion, and close to the tarsus attach a strip
of plaster. When firmly adherent draw it sufficiently to efface the
entropion and attach it to the skin of the face.
This failing, Gaillard’s sutures may succeed. With a pair of forceps
with looped, transversely elongated blades, pinch up skin and muscle
sufficient to correct the entropion, and passing a needle twice through
this fold with an interval of 3 mm., tie the suture over a small roll of
cotton. The stitches may be removed in two days and the cicatrices may
permanently obviate the deformity.
The older plastic operation is more trustworthy: The skin of the
affected lid is pinched up to such an extent in length and breadth, as
to correct the entropion and is then excised with sharp scissors or
bistuory so as to leave a long elliptical sore. The edges of this are
then carefully sutured together and the resulting union corrects
deformity. In case the entropion is caused by an old standing cicatrix,
it may be necessary, first, to make a careful incision along the edge of
the lid so as to separate the tarsus and conjunctiva from the cilia and
Meibomian ducts, and then to proceed with the plastic operation on the
skin.