Entropium — Inversion of the Eyelids
This disease we do not find mentioned by any of the writers on canine pathology: nevertheless, we are led to believe that it is not an uncommon form of ophthalmia; and we must express our surprise that it should have escaped the attention of such close observers as Blaine and Youatt.
The acute form of the disease resulting from, or attending, simple ophthalmia, we have often witnessed, but the chronic form, of which we more particularly speak, is more rare. We have seen three cases of the latter, and, no doubt, might have found many more if our opportunities of studying canine pathology were equal to those of the English writers. The inversion of the eyelids upon the globe is accompanied with pain and irritation, swelling and inflammation, both of the lids and eye, which ultimately renders the dog almost useless, if not entirely blind.
Causes
. — Neglected chronic ophthalmia was, no doubt, the cause of the disease in two cases, a setter and a pointer, while the other, in a hound, was the result of an acute attack of ophthalmia brought on by scalding with hot pitch thrown upon the animal. Some of this substance entered the eye, while a large portion adhered to the muzzle and lids. The eye, as well as the lids, became inflamed; the latter, being puffed up and contracted on their edges, were necessarily drawn inwards from the tension of the parts, and double entropium was thus produced. The inflammation and tumefaction of the parts continued for a considerable time, and when ultimately reduced by the application of tepid fomentations, the skin appeared greatly relaxed; and the muscular fibres having lost their power of support or contractility, owing to their long quiescence, seemed no longer able to keep their lids in their proper situation; the edges therefore remained in the abnormous position previously assumed.
By this strange condition of the parts, the eyeball continued greatly irritated by the constant friction of the lashes; water was continually flowing over the lids, and from its irritating character produced considerable excoriation of the face and muzzle. The conjunctiva remained inflamed, the cornea in due course became ulcerous, and the eye was ultimately destroyed by the discharge of its contents. This was the course and final termination of the disease in the case of the hound above referred to, all of which disastrous results might have been prevented by proper management.
Treatment.
— When in England, we sent to the United States a fine bred pointer dog, designed as a present for one of our sporting friends. This animal travelled from Leeds to Liverpool, chained on top of the railroad cars; the journey occupied several hours, daring which the weather was cold and boisterous, and we noticed on his arrival at the latter place that his eyes were watering and somewhat inflamed. On examining them more particularly, we were enabled to extract several pieces of cinder from under the lids, which seemed to relieve him somewhat. He went to sea, in the care of the steward, on the following day; and remained on deck exposed to the inclemency of the weather during a long voyage. When he arrived in Philadelphia, the inflammation, we were informed, was very considerable, occasioned by the presence of some other small particles of cinder that may have escaped our attention before shipping him. The presence of these foreign substances in the eye, in connection with the salt spray and irritating atmosphere, greatly aggravated the ophthalmia, and resolved it into a chronic affection, which ultimately resulted in entropium.
"Fop" was hunted during the same autumn, which no doubt increased the malady to a considerable extent; and before the hunting season was over, the dog was rendered almost useless: the lids becoming so much swollen and the irritation so considerable, that it was deemed cruel to allow him to go into the field.
When we saw him some time in the course of the same winter, the lower lids of both eyes were completely inverted on their globes, and the conjunctival inflammation and flow of tears considerable.
The eyes seemed contracted within their sockets, and at times were nearly hidden from view, the corneas were somewhat opaque, the photophobia intolerable, and the animal showed evident signs of extreme pain, by his restless anxiety and constant efforts at scratching and rubbing the eyes.
Under the judicious application of cooling astringent collyria, and other remediate means, the irritation and pain of the parts were relieved, and the lids somewhat retracted.
"Fop" remained in this condition till the following autumn, suffering at times considerably from the increased inflammation and tumefaction of the lids, which continued obstinately to persist, insomuch that when turned out by the pressure of the fingers on them, they immediately contracted, and were forced inwards on the ball when freed from the fingers.
Finding that no external application was of any permanent benefit, we resolved to have resort to the same operation we saw practised in ihe Parisian hospitals for the cure of a similar malformation in the human subject. To insure quiet we enclosed the body of the dog in a case, made stationary and sufficiently small to prevent struggling, with the head firmly fixed by a sliding door, as represented in the accompanying drawing. The mouth was kept closed by a small strap passed around the muzzle. This method of fixing a strong dog, we consider the best ever adopted for all nice operations on the face. The first step in the operation was to pinch up a portion of the lax skin of the diseased lid and pass three needles, armed with silk ligatures, successively through the base of the upraised integuments. |
| One needle approximating the external canthus, another the internal, and
a third midway between these two points, as represented in the annexed
drawing. The next step was lo raise up the integuments included in the ligature, and, by means of a pair of sharp scissors, cut off the super-abundant skin as near to the ligatures as possible; having care however to leave sufficient substance included in the ligatures, to prevent their sloughing out before adhesion has taken place. The next and last step of the operation was, to draw the edges of the wound together by tying each ligature, which procedure immediately secured the lid and held it firmly in its natural position. The ligatures were now cut short, and a large wire muzzle, covered over with some dark substance on the operated eye, being put on him, and his legs hobbled with a piece of strong twine, more effectually to prevent his scratching the head, "Fop" was then set at liberty, and soon became reconciled to this eye-shade. |
The hemorrhage was trifling, the wound healed up by the first intention and the ligatures were drawn away in a few days, when a perfect cure was effected — the conjunctiva having lost its inflammatory appearance, and the cornea having again become quite transparent.
The other eye was operated on in the same way and with like success. In the first operation we cut away the loose flaccid integuments only; whereas, in the second, we snipped small longitudinal fibres from the cartilage itself, and the operation consequently was more perfect, if possible, than in the first instance.
The eyes were now perfectly restored, and remained well during the whole of the shooting season, after which we lost sight of our patient, he having accompanied one of our friends as a "compagnon de voyage" on a commercial expedition to Santa Fe, and, when on his return, had the misfortune to lose "Fop," who was carried off into captivity by some prowling Camanches, who no doubt have long since sacrificed him to the Great Spirit in celebrating the buffalo or wolf dance.
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