What is entropion?
Entropion is a condition where one or both eyelids roll inwards. This not only irritates the surface of the eye but can also result in ‘trichiasis‘. This is when hairs from the eyelid skin contact the surface of the eye causing further irritation and damage.
Types of entropion
- Primary (Breed related) – Entropion can occur in any breed however it is more common in breeds such as the Bulldog, Spaniels, Shar-Pei and Chow Chow. Entropion can occur due to overlong eyelids, excessive facial skin or exaggerated skin folds. Persian and Maine Coone cats are also over-represented.
- Secondary to ocular pain – A painful eye may cause the eyelids to go into spasm and roll inwards. It is therefore important that entropion is assessed following application of local anaesthetic drops to accurately determine the cause.
- Previous trauma or surgery – Any scarring from eyelid trauma or previous surgery can cause the eyelid shape to be distorted resulting in entropion.
Clinical Signs
- Visible in-rolling of the eyelids
- Excessive tear production
- Increased rubbing of the eyes and face
- Ocular redness
- Increased blinking or eyes appearing closed
- Corneal ulcers
Treatment
Surgical correction is required in most cases and aims to address the cause of entropion, which can vary greatly between patients. This may require simple shortening of the eyelids, removal of strips of eyelid skin to evert the eyelid, or a combination of both. Excessive facial skin and exaggerated facial folds may also need to be removed in more complex cases.
In immature patients, generally less than 6 months old, ‘tacking’ of the eyelids by placing temporary sutures in the surrounding skin is used to alleviate the symptoms of entropion until facial conformation is more mature. Permanent surgical correction can then be performed.
More novel techniques such as Hyaluronic Acid (HA) subdermal filler injections are more commonly being utilised. These are particularly useful in older cats with entropion that would not tolerate general anaesthesia.
In all cases it is important to note that several surgical procedures may need to be performed for adequate correction to be achieved, especially in young patients or complex cases.
