Felis ISSN 2398-2950

Eyelid: abnormality

Contributor(s): Dennis E Brooks, David L Williams, James Oliver

Introduction

  • Entropion/agenesis/colobomaproduce irritation because eyelid hair rubs on cornea, causing serous ocular discharge, conjunctival hyperemia, corneal ulceration.
  • Ectropion- lower lid droops exposing bulbar and palpebral conjunctiva - infections and conjunctival hyperemia common.
  • Cause:
    • Entropion- anatomical (rare), spastic, post-traumatic (cicatricial).
    • Agenesis/coloboma- congenital hereditary malformation of lids, sometimes associated with optic disc and other ocular abnormalities.
    • Ectropion- anatomical (rare cf. dog), post-traumatic, neoplastic.
  • Signs: serous/purulent ocular discharge, self-trauma, conjunctival hyperemia, corneal damage.
  • Treatment: surgical repair.
  • Prognosis: generally good.
  • Some surgical repairs complicated and may require referral.

Pathogenesis

Etiology

  • Congenital: hereditary agenesis/coloboma, entropion (may not become clinically significant until cat reaches a few months of age).
  • Acquired: post-traumatic, neoplasia.
  • Secondary: to anterior segment pain.

Pathophysiology

  • Anatomical entropion: seen in Persians Persian longhair with shallow orbits and relatively prominent eyes, generally at medial canthus.
  • Spastic entropion: occurs secondary to anterior segment pain (corneal, anterior uvea) and globe retraction. Can be relieved with topical anesthesia if corneal pain responsible.
  • Cicatricial entropion: post-traumatic healing and fibrosis may distort lids Eyelid: laceration. Important if repairing lid lacerations to correctly appose lid margins.
  • Agenesis/coloboma: congenital lack of lid margin, forehead facial hairs impinge directly on cornea   Eyelid: coloboma or agenesis  .
  • Ectropion: rarely anatomical cf. dog, may be secondary to trauma Eyelid: laceration and aberrant healing, lid neoplasia Eyelid and conjunctiva: neoplasia distorting normal lid/globe relationship.
  • Entropion/agenesis/coloboma result in corneal damage because facial hairs abrade corneal surface (trichiasis), may cause reflex uveitis   →   secondary infection   →   progressive ulceration may   →   self-trauma.
  • Agenesis/coloboma may cause exposure keratitis even if trichiasis does not occur.
  • Ectropion exposes lower bulbar and palpebral conjunctiva   →   secondary infections more likely.
  • Epiphora Epiphora may result from inefficient blinking and tear drainage.

Timecourse

  • Variable.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Glaze M B (1997) Ophthalmic disease and its management. Vet Clin North Am Small Anim Pract 27 (6), 1505-1522 PubMed.

Other sources of information

  • Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology. 2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4


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