Eye Disorders associated with the Eyelids


What is Entropion ?


Entropion is an eye condition in which all or part of the edge of the eyelid(s) “roll/turn” inwards.  This results in the eyelashes rubbing against the surface of the eyeball, causing chronic irritation, abrasion and damage to the cornea.


Although entropion usually affects the lower eyelid(s), it can also occur on the upper eyelid(s).


Usually both eyes are involved, when the condition is referred to as “bilateral entropion.  However, the condition may be confined to one eye.


There is documented evidence that the condition has been identified in most breeds of dog.  However, some breeds, particularly breeds with pronounced facial folds of skin, are more commonly affected than other breeds. Obviously, the Bedlington terrier does not come within this category.


In Bedlington Terriers entropion generally occurs within the first year.  The condition is usually,but not necessarily, bilateral  and affects the lower outer part of the eyelid(s) or, in severe cases, the entire lower eyelid(s).



Causes of Entropion.


Most cases of entropion have a genetic basis - these are referred to as primary or developmental/congenital entropion and usually develop before the dog is one year old.


In those breeds known to have a high incidence of entropion the condition frequently occurs indirectly as a consequence of the inheritance of conformational facial characteristics, resulting in a predisposition to the condition.


The situation in Bedlington Terriers is unclear.  Although some authoities claim that entropion is recessively inherited, others consider that it is inherited as a dominant trait.  However, the variability of both occurance and expression make it possible that spastic entropion in Bedlington Terriers is polygenetically determined.


On the other hand secondary or acquired entropion may be caused by a variety of factors, e.g. eyelid trauma or spasms, injury, chronic inflammation/infection, loss of muscle/skin tone etc.  It can occur in dogs of any breed and at any age, although it is generally associated with older dogs.



Symptoms.


The displayed symptoms can vary and and are similar to those that occur with any condition that results in irritation/damage to the eye:





Diagnosis.


The veterinary surgeon will carry out a thorough examination of the eye(s) taking particular note of the position of the eyelid margins in relation to the surface of the eye.


The eye(s) may be irrigated with fluorescein dye in order to determine the extent of any damage to the cornea.


In Bedlington Terriers it is important that the veterinary surgeon distinguishes between epiphora (excessive tear production) caused by blocked/partially blocked tear ducts and that caused by entropion



Treatment.


The standard treatment, in all but the mildest cases, involves surgery.  This usually involves removing a small section of the eyelid.  The two sides of the incision are then sutured together – this has the effect of “tightening” the eyelid and pulling it into the right position.


Note that definitive surgery is often delayed in young dogs that develop entropion.  In this situation a temporary surgical technique, known as “eyelid tacking”, is often carried out and the standard surgical procedure delayed until the dog has developed full head/facial characteristics.


Post operative care generally involves the topical application of an antibiotic/other type of ointment in order to minimise the risk of infection and to promote healing.  A “veterinary collar” is usually fitted during the immediate post operative period in order to prevent the dog scratching at its eyes.  A careful watch must be maintained for any indications of infection.


The veterinary surgeon will usually ask to see the dog about 10-14 days after surgery in order to ensure that everything is progressing satisfactorily and to remove the sutures.


Prognosis is excellent if the corrective surgery is carried out BEFORE there is any corneal damage and in most cases the condition does not re-occur.




Entropion






Introduction


Distichiasis is one of the eye conditions reported in the KC Health Survey (2004) as affecting Bedligton terriers.  It differs from entropian in that it is a condition in which extra eyelashes (termed distichiae) grow out from the inner margin of the eyelid whereas entropion results from an inward roll of the eyelid that causes eye irritation from normal eyelashes.

They are usually multiple and sometimes more than one arises from a duct.  They can affect either the upper or lower eyelid and are usually bilateral. The lower eyelids of dogs usually have no eyelashes.  These hairs may or may not come in contact with the cornea.  This depends on whether they are thick/stiff or fine, and in which direction they are growing, i.e. whether or not they are directed inwards).


Distichiasis is generally seen most often in puppies or young adults, and is typically diagnosed before the dog is three years.



Symptoms of Distichiasis


The symptoms or clinical signs vary with the severity of the condition and relates to:



Note that the presence of distichiae often cause no symptoms because the hairs are soft.


However, in other cases there may be indications of discomfort which become more obvious/severe as the condition develops, especially if the hairs are long and stiff:



The veterinary surgeon will carry out a thorough examination of the eye and associated tissues following the administration of a local anaesthetic.  Fluorescein staining of the cornea, to assess the extent of any damage to the cornea, and a Schirmer tear test, to measure the level of tear production, are generally carried out.



Treatment.


Each case is managed individually.


Dogs with short, fine distichia, that do not appear to be causing any problems, do not generally require any form of treatment.


With dogs that exhibit mild clinical signs the treatment usually involves the use of ophthalmic lubricants to protect the cornea and coat the lashes with a lubricant film.


Although, in some cases, the distichiae may be manually removed, it is important to note that this is not a permanent solution to the problem.  Hairs that have been mechanically plucked will re-grow within four to five weeks.  This will necessitate further treatment.


In more severe cases, particularly where the dog is in obvious discomfort or if there are indications of damage to the surface of the cornea, your veterinary surgeon may recommend referral to a veterinary ophthalmologist for surgical treatment.  These treatments involve the use of a general anaesthetic.


Although surgical removal of the affected part of the eyelid may be an option if only a small number of distichiae are present, other types of surgical procedure are available:



The aim of these procedures is two-fold: firstly, to remove the offending eyelashes and secondly, to destroy the hair follicles so that the distichiae do not recur.


However, all hairs may not be destroyed on the day of surgery and for a complete removal more than one treatment may be required.


Once the hairs have been removed permanently, the prognosis is good. However, dogs with distichiasis should not be used for breeding, because of the hereditary aspects.







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