Contributors: Dennis E Brooks, David L Williams, James Oliver
Species: Feline | Classification: Diseases
Introduction Pathogenesis Diagnosis Treatment Outcomes Further Reading
- 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.
- 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.
- Ocular discharge Eye: ocular discharge - overview.
- Congenital disease Eye: congenital ocular disorders usually present with clinical signs 3-6 months of age.
- Anatomical entropion seen in Persian Persian longhair especially at medial canthus.
- Agenesis/coloboma of lids, with other ocular colobomatous defects, recorded in Snow Leopards.
- Surgical repair Eyelid: wedge resection.
- 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.
- 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 .
- 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.
- Ocular discharge.
- Red eye.
- Ocular discharge Epiphora.
- Facial hairs impinging on cornea (trichiasis).
- Corneal damage, ranging from subtle disruption to frank ulceration Eye: corneal ulcer.
- Mild reflex uveitis Anterior uvea: traumatic uveitis, depending on degree of corneal damage.
- Ophthalmoscopic examination Ophthalmoscopy: direct given the diagnosis.
- Important to distinguish anatomical from spastic entropion (use topical anesthesia to relieve spastic entropion).
Initial Symptomatic Treatment
- Surgical correction:
- Hotz-Celsus procedure for entropion.
- Eyelid wedge resection Eyelid: wedge resection for coloboma/agenesis or for ectropion from abnormally long lower eyelid.
- Treat underlying cause if entropion is secondary to anterior segment pain.
- If successful, surgical correction results in complete resolution of signs.
- Good, with adequate surgical method.
- Consider referral.
Expected Response to Treatment
- Facial hairs no longer impinging on cornea.
- Ectropion: bulbar and palpebral conjunctiva no longer exposed.
Reasons for Treatment Failure
- Poor surgery can make situation worse.
- Topical anesthetics are used for diagnostic purposes, not therapy, as they are toxic to the corneal epithelium.
- 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