Comparison of entropion outcome with and without intervention in Romane and Ile de France sheep breeds.

BACKGROUND: Congenital entropion is the most frequent ocular disorder in newborn lambs of certain sheep breeds, which, if not treated, can result in complete blindness and death due to starvation. OBJECTIVES: The aims of this study were to compare the spontaneous healing of entropion in two breeds and assess the outcome of cases with and without therapeutic intervention. METHODS: A total of 158 entropion cases (119 Ile de France and 39 Romane) were investigated, and swab samples were collected from the cornea and conjunctiva of 73 of the affected lambs for bacteriological investigation. In addition, an ocular intervention was carried out in 123 affected animals. RESULTS: The Romane breed developed entropion at an average age of 7 days compared to the Ile de France, which developed it at an average age of 1 day. Likewise, significant differences were found between bilateral and unilateral involvement in both breeds. Meanwhile, 22.1% of cases recovered spontaneously, and the highest rate of spontaneous recovery without intervention was observed in the Romane breed (66%). Bacteria isolated from ocular samples included Staphylococcus spp. (42.5%), Bacillus spp. (21.9%), Trueperella pyogenes (13.7%), Corynebacterium spp. (12.3%) and Escherichia coli (9.6%). CONCLUSIONS: The results of the study showed that the onset time of entropion, bilateral involvement, the severity of the process and the need for re-treatment were higher in the Ile de France breed than in the Romane breed. Likewise, the Romane breed showed a higher degree of spontaneous recovery of entropion.

Long-term success rate of entropion surgery is equivalent in juvenile and adult dogs.

OBJECTIVE: To compare long-term outcomes of lower lid entropion surgery performed in juvenile dogs versus adult dogs and evaluate the success rate of temporary tacking procedures in dogs < 1 year of age. ANIMALS: 116 client-owned dogs. METHODS: A retrospective study was performed evaluating dogs younger than 3 years old diagnosed with primary lower lid entropion between 2010 and 2020. Recurrence of entropion following temporary tacking sutures was evaluated. Surgical outcomes were evaluated of entropion surgery in dogs < and > 1 year of age. RESULTS: 44 dogs with entropion (71 eyes) had a temporary tacking procedure. The entropion resolved in 36.6% of eyes, requiring no further therapy. The median age of dogs successfully treated with a temporary tacking procedure was younger than those that failed. Forty-seven dogs (75 eyes) had entropion surgery at maturity, and 52 dogs (79 eyes) were juvenile. Twenty-seven dogs had temporary tacking procedure prior to surgery, accounting for the difference in number. There was no statistically significant difference in the recurrence rate of entropion between eyes of adult (6/75 [8%]) and juvenile dogs (10/79 [12.7%]) following surgery. CLINICAL RELEVANCE: Entropion surgery in juvenile dogs is not associated with a higher risk of recurrence and need not be delayed until dogs are older than 1 year of age.

[Subdermal hyaluronic acid injection treatment of an upper eyelid entropion in a rabbit]. / Subdermale Hyaluronsäureinjektion zur Behandlung eines Oberlidentropiums bei einem Kaninchen.

Surgical correction is the typical treatment for an entropion. However, considerable anesthetic risk exists for a subset of patients, particularly rabbits and guinea pigs. In a high number of these cases, this represents the main reason for reluctance to treat an entropion. The following report describes the case of a 9-year-old rabbit with a superficial cornea defect and a mild entropion of the upper eyelid. Eversion of the eyelid from a mild entropion to a normal position was attained by the subdermal injection of a hyaluronic acid filler (Alayna SG 24 Distinct®, BSC Medical Devices GmbH, Munich, Germany) without necessitating general anesthesia or sedation. Following a period of 273 days, a relapse occurred which was subsequently successfully treated with a repeat injection. An entropion of the contralateral eye became evident during the follow-up period and was also effectively managed by a single subdermal filler injection. In the reported case, treatment with subdermal hyaluronic acid injection proved to be well tolerated and efficacious.

A case of lipogranulomatous conjunctivitis in a horse.

OBJECTIVE: To describe a case of lipogranulomatous conjunctivitis in a horse. ANIMAL STUDIED: A client-owned 12-year-old Standardbred gelding presenting with chronic conjunctivitis and palpebral masses. METHODS: Complete ophthalmic examination, surgical excision, histopathology, and bacterial culture of biopsy samples were performed. RESULTS: Upper and lower eyelids of both eyes were affected, with multiple yellow-to-white nodules on the palpebral conjunctiva, adjacent to the eyelid margin. Nodule removal was achieved via partial tarsal plate excision. Histopathological examination revealed granulomatous inflammation and large droplets of presumed free lipid in the conjunctival lamina propria. The animal was diagnosed with lipogranulomatous conjunctivitis. No postoperative ocular discomfort was observed for months; however, 3 years later, new conjunctival nodules were noticed, requiring a second surgical procedure on three of the eyelids. Transient entropion in the left lower eyelid was observed 2 months after the second surgery, and no recurrence of conjunctival nodules was observed after 18 months of follow-up. CONCLUSION: To our knowledge, this is the first report of lipogranulomatous conjunctivitis in horses.

Clostridial panophthalmitis - An unusual case of localised malignant oedema in Merino lambs associated with Clostridium chauvoei.

The authors report an unusual case of Clostridium chauvoei causing severe panophthalmitis in Merino lambs. More than half of the lambs affected survived, which is unusual for clostridial disease; however, there have been reports in humans that the mortality risk for ocular gas gangrene is lower than when other body parts are affected. A combination of factors in this case included environmental contamination (specific to a particular paddock), genetics predisposing to entropion (lambs born of maiden 2-year-old ewes with some inbreeding), the practice of manually everting eyelids for the entropion and vaccination strategies. C. chauvoei was cultured in pure growth from the eye of a lamb affected by severe panophthalmitis. Histopathology was consistent with severe acute infection, and microscopic sections showed Gram-positive organisms associated with the inflammatory response in the eye. In the acutely affected animal examined there were no signs that the lesions were long-standing. Animals that recovered had one or both eyes destroyed. This report describes that malignant oedema in sheep due to C. chauvoei can manifest as acute and severe panophthalmitis. The case fatality rate of lambs with panophthalmitis was less than 50%, lower than normally occurs for clostridial diseases. Clostridial vaccination of the ewes may have provided a low level of protection in reducing the case fatality rate in the affected lambs as well localisation of the infection from the blood-ocular barrier.

Prevalence and characteristics of ocular diseases in Sphynx cats: A retrospective assessment (2012-2021) and comparison with non-Sphynx cats.

PURPOSE: To describe the prevalence of ocular diseases in Sphynx cats, and compare disease characteristics with other feline breeds. METHODS: Medical records of Sphynx cats presented to an ophthalmology referral center between 1/2012 and 4/2021 were examined. Cats of other breeds examined during the same period served as controls. RESULTS: One hundred ten Sphynx cats were examined during the study period, diagnosed with corneal sequestrum (n = 42 cats), lower eyelid entropion (n = 25), presumed herpetic keratoconjunctivitis (n = 19), conjunctivitis (n = 7), corneal ulcers (n = 6), nasolacrimal duct atresia/obstruction (n = 6), corneal dystrophy (n = 3), eosinophilic keratitis (n = 2), uveitis (n = 2), non-ulcerative keratitis (n = 1), and cataract (n = 1). Corneal sequestrum was significantly more common in Sphynx versus non-Sphynx cats (odds ratio = 8.0, 95% CI = 5.3-12.2, p < .001), and age of diagnosis was significantly younger in Sphynx cats (2.0 ± 1.5 years vs. 5.9 ± 4.0 years, p < .001). Corneal sequestrum recurrence was noted in 19.4% Sphynx eyes and 6.4% non-Sphynx eyes undergoing surgery (p = .015). Lower eyelid entropion-most often bilateral (80%)-was significantly more common in Sphynx versus non-Sphynx cats (odds ratio = 4.1, 95% CI = 2.3-7.1, p < .001), and age of diagnosis was significantly younger in Sphynx cats (0.9 ± 1.4 years vs. 3.5 ± 3.3 years, p < .005). CONCLUSIONS: Corneal sequestrum and entropion were overrepresented and diagnosed at an earlier age in Sphynx cats when compared with the general feline population. Given the high prevalence, early age of onset, and relatively high recurrence of corneal sequestrum in Sphynx cats, further studies are warranted to better understand etiopathogenesis and preferred therapies.

Lower lid entropion in dogs: A modified technique of the combined Hotz-Celsus and wedge resection procedure.

BACKGROUND: This study aimed to describe a modification of the combined Hotz-Celsus and wedge resection technique for the treatment of lower lid entropion in dogs and evaluate its success rate. METHODS: To reduce tissue trauma, facilitate tissue handling and shorten the surgical time, shortening of the eyelid was performed by excising a rectangular piece of the eyelid margin only, in the central section, extending to but not below the first Hotz-Celsus incision. The eyelid margin surgical wound was then sutured before excision of the Hotz-Celsus crescent which had been surgically scored at the start of surgery. Records of 31 dogs were reviewed for signalment, outcome, need for further surgery, and follow up from 6 to 48 months after surgery. RESULTS: Sixty-one eyes with lower lid entropion were treated. The most common breeds were English bulldog and English cocker spaniel and the median age was 16 months. The success rate for a single entropion correction surgery was 98.4%. One eyelid required a second surgical correction and four eyelids of three large breed dogs had wound breakdown. CONCLUSIONS: This modified technique is successful at correcting lower eyelid entropion associated with overlong eyelid length in dogs while being technically easier to perform.

A genome-wide significant association on chromosome 15 for congenital entropion in Swiss White Alpine sheep.

Entropion is a known congenital disorder in sheep presumed to be heritable but no causative genetic variant has been reported. Affected lambs show a variable inward rolling of the lower eyelids leading to blindness in severe cases. In Switzerland, the Swiss White Alpine (SWA) breed showed a significantly higher prevalence for entropion than other breeds. A GWAS using 150 SWA sheep (90 affected lambs and 60 controls), based on 600k SNP data, revealed a genome-wide significant signal on chromosome 15. The 0.2 Mb associated region contains functional candidate genes, SMTNL1 and CTNND1. Pathogenic variants in human CTNND1 cause blepharocheilodontic syndrome 2, a rare disorder including eyelid anomalies, and SMTNL1 regulates contraction and relaxation of skeletal and smooth muscle. WGS of a single entropion-affected lamb revealed two private missense variants in SMTNL1 and CTNND1. Subsequent genotyping of both variants in 231 phenotyped SWA sheep was performed. The SMTNL1 variant p.(Asp452Asn) affects an evolutionary conserved residue within an important domain and represents a rare allele, which occurred also in controls. The p.(Glu943Lys) variant in CTNND1 represents a common variant unlikely to cause entropion as the mutant allele occurred more frequently in non-affected sheep. Therefore, we propose that these protein-changing variants are unlikely to explain the phenotype. Additionally, WGS of three further disconcordant pairs of full siblings was carried out but revealed no obvious causative variant. Finally, we conclude that entropion represents a more complex disease caused by different non-coding regulatory variants.

Surgical management of bilateral, upper and lower eyelid entropion in 27 Shar Pei dogs, using the Stades forced granulation procedure of the upper eyelid only.

Aims: To evaluate the outcome of surgical management of entropion of the upper and lower eyelids in Shar Pei dogs which had previously undergone temporary palpebral tacking, using the Stades forced granulation procedure of the upper eyelid only.Methods: Medical records were retrospectively searched to identify Shar Pei dogs referred for bilateral entropion of both the lower and upper eyelids, and that were treated with the forced granulation procedure of the upper eyelid only. Dogs were included if they had previously undergone unsuccessful temporary palpebral tacking and had at least three follow-up examinations in the 30 days following surgery.Results: Twenty-seven Shar Pei dogs with a median age of 7.9 (min 4, max 24) months were included in the study. Before surgery, all dogs showed signs of severe ocular discomfort with bilateral keratitis and visual deficit due to blepharospasm, enophthalmos and protrusion of the third eyelid. In 13/54 eyes, keratitis was associated with a corneal ulcer. When re-examined 4 weeks after surgery, correction of the upper eyelid entropion and associated trichiasis resolved ocular signs in 50/54 eyes. Mild bilateral lower entropion remained in two dogs postoperatively, which underwent revision surgery with the Hotz-Celsus technique. There were no cases of long-term recurrence of entropion or ocular irritation in the 38 eyes (19 dogs) which were re-examined 1 year after surgery.Conclusion and clinical relevance: The forced granulation procedure performed on the upper eyelid only was effective for correction of entropion in the Shar Pei dogs included in this study. In our experience, it is preferable to operate on the upper eyelid alone, rather than attempting to correct upper and lower entropion during the same surgical operation. The dog can then be reassessed a few weeks later to determine whether the lower entropion is anatomical or secondary to the severe blepharospasm resulting from the painful ocular irritation.

The use of hyaluronic acid subdermal filler for entropion in canines and felines: 40 cases.

PURPOSE: To evaluate the use of hyaluronic acid (HA) subdermal filler in canines and felines for entropion. METHODS: Complete ophthalmologic examination was performed by a board-certified veterinary ophthalmologist or ABVO-approved resident. Each case was characterized as primary, secondary, spastic or cicatricial entropion. HA subdermal filler, specifically Restylane® and Restylane Silk® , were utilized in dogs and cats, respectively. Subdermal injection was performed 1-2 mm from the eyelid margin in the affected area until normal eyelid conformation was achieved. All patients did not require sedation or general anesthesia. RESULTS: Forty animals (28 dogs and 12 cats) were included in the study. No local reaction to the HA dermal filler or any other complications other than minor skin bleeding at the injection sites were noted in all patients. Resolution of entropion and secondary complications including corneal ulceration, epiphora, and blepharospasm were noted by the first week after injection in the majority of cases. Three canines and one feline case failed to resolve the entropion, necessitating additional permanent surgical intervention. Two cases were submitted for histopathological analysis. Median follow-up time for all cases was 152.5 days (mean: 194.6 ± 142.7 days; range 9-419 days). Five patients died or were euthanized during the study for unrelated causes. CONCLUSIONS: Hyaluronic acid (HA) subdermal filler appears to be a safe, easy, reliable method for mild to moderate eyelid entropion not requiring general anesthesia. This procedure may be especially appropriate for geriatric patients and those with high anesthetic risk with entropion.

Evaluation of transconjunctival thermal electrocautery for treatment of canine distichiasis: 88 eyelids (2013-2016).

OBJECTIVE: To describe a successful, simple treatment for canine distichiasis. ANIMALS STUDIED: Client-owned dogs presenting to Veterinary Specialty and Emergency Center, Levittown, Pennsylvania. PROCEDURE: Retrospective analysis of medical records for canine patients that underwent transconjunctival thermal electrocautery treatment (TCEC) for distichiasis alone or with concurrent eyelid surgery between 2013 and 2016. Fifty eyes of 26 dogs (n = 88 eyelids) were included in the study. Sixty-five eyelids (74%) were treated for distichia only, while 23 eyelids (26%) underwent concurrent eyelid surgery. Successful treatment was defined as resolution of clinical signs attributable to distichiasis. Forty-eight of 50 eyes (96%) were successfully treated with a single TCEC treatment (mean follow-up 187 ± 222 days). Sixty-one of 88 eyelids (69%) had no distichia at any follow-up time. Twenty-two eyelids (25%) had recurrence at or near a previously treated site (mean 150 ± 152 days). Of the eyes with recurrent distichia, all but 2 (91%) remained asymptomatic, requiring no further treatment. One dog with extensive TCEC treatment had significant recurrence on all eyelids requiring retreatment that resulted in focal entropion of 1 eyelid. Transient eyelid margin pigment loss and mild-to-moderate eyelid swelling were noted in all treated eyelids postoperatively. Suspected treatment site infection occurred 2 days postoperatively in 2/50 eyes (4%) of 1 patient. Two of 10 eyes (20%) with extensive eyelid treatment developed qualitative tear film deficiency OU (554 days postoperatively) and responded to topical tear stimulant therapy. CONCLUSION: TCEC is a successful, simple treatment for canine distichiasis.

Shared rhytidectomy continued to lateral canthoplasty in a Mastiff with excessive facial folding and macroblepharon.

A 3.5-year-old male Neapolitan Mastiff was presented with an obstructed visual axis because of excessive facial skin folds, brow droop, macroblepharon, upper eyelid entropion and lower ectropion-entropion. To address these major defects a technique was performed which combines rhytidectomy with shortening of the palpebral fissure and stabilization of the lateral canthus. Postoperatively the dog showed an unobstructed visual axis with comfortable and symmetrical eyes.

Surgical correction of congenital entropion in related Boer goat kids using a combination Hotz-Celsus and lateral eyelid wedge resection procedure.

Five related Boer goat kids (≤4 months of age) were presented to the University of Missouri, Veterinary Teaching Hospital (MU-VMTH) with epiphora and blepharospasm of several weeks duration and commencing prior to 1 month of age in all animals. Clinical examination confirmed euryblepharon and entropion bilaterally in two females and one male and unilaterally in two female kids. Deep stromal corneal ulceration was present in two eyes, and corneal granulation tissue and fibrosis were present in half (5/10) the affected eyes. A combination Hotz-Celsus and lateral eyelid wedge resection procedure was performed on all affected eyelids. Recheck examinations and long-term follow-up confirmed resolution of the entropion, preservation of normal eyelid conformation, and restoration of ocular comfort. Pedigree analysis ruled out sex-linked and autosomal dominant inheritance patterns; a specific mode of inheritance could not be determined. The Boer goat breed may be at increased risk for the development of entropion. This cases series represents the first report of entropion in the caprine species.

Nonsutured Hotz-Celsus technique performed by CO2 laser in two dogs and two cats.

It is described a new version of modified Hotz-Celsus technique performed in four patients, two cats and two dogs. The surgery was carried out using CO(2) laser in order to avoid bleeding and decrease the anesthetic time. Besides, the wound created was not sutured and it healed by secondary intention without any complication. As a conclusion, this modification is a successful alternative to treat entropion in a safe and fast way.

Surgical management and outcome of lower eyelid entropion in 124 cats.

OBJECTIVES: To evaluate the success rate of various surgical techniques for the management of lower eyelid entropion in cats. DESIGN: Retrospective study. Animals studied One hundred and twenty-four cats with surgical correction of lower eyelid entropion of 200 eyes over a 13 year period. METHODS: Records of 124 cats were reviewed for signalment, type of entropion, surgical procedure performed and post-operative result. RESULTS: Combinations of the Hotz-Celsus (HC), lateral canthal closure and full thickness wedge resection techniques were used to treat 64 bilateral and 60 unilateral cases of lower lid entropion. Twenty-three cats were under a year of age, 52 cats were aged between 2 and 8 years and 49 were over 8 years old. The overall success rate for a single surgical procedure (which may consist of multiple techniques) to correct lower eyelid entropion was 96.0% per eye. The remaining 4.0% had the entropion resolved with a second surgery. A combined HC and lateral canthal closure had a 99.21% success rate of resolving lower lid entropion. Geriatric cats were the most likely age group to develop corneal sequestra; 37% of cats in this group presented with entropion and corneal sequestra concurrently. Seventeen percent of cats that presented with unilateral entropion and did not have prophylactic surgery on the fellow eye went on to develop entropion in the fellow eye. CONCLUSIONS: A combined HC and lateral canthal closure was the most effective surgical technique in managing lower eyelid entropion of cats in our study. Prophylactic lateral canthal closure in the unaffected eye is recommended.

Feline entropion: a case series of 50 affected animals (2003-2008).

AIM: To evaluate the signalment, clinical signs, and etiopathogenesis of entropion in 50 cats. METHODS: Signalment and history of 50 cases of entropion in cats presented to a referral ophthalmology clinic. Animals were examined with direct and indirect ophthalmoscopy and slit-lamp biomicroscopy. Animals were treated surgically with a Hotz-Celsus procedure and results of surgery were evaluated between 4 and 22 weeks. RESULTS: Sixteen cats were young (mean age 4.1 +/- 3.6 years) with pre-existing irritative ocular surface conditions such as conjunctivitis, corneal ulceration or sequestrum. Twenty-six cats were relatively older (mean age 11.3 +/- 2.2 years) with involutional entropion with or without enophthalmos, presumed to result from a reduction in orbital tissue. Five cats were Persians with entropion associated with brachycephalic facial anatomy, whereas three were entire young adult male Maine Coones with in-turning associated with excessive facial 'jowl' tissue. Surgical treatment was curative in the majority of cases after one surgery although an increased amount of eyelid tissue was required to be removed for correction compared with similar surgery in the dog. DISCUSSION: This study has shown that entropion in cats may be caused in young animals as a result of continued blepharospasm related to irritative causes such as conjunctivitis or corneal ulceration or in older animals with lid laxity or globe enophthalmos. Lid in-turning was also seen in Persian and Maine Coone breeds.

Surgical correction of periocular fat pads and entropion in a potbellied pig (Sus scrofa).

A 16-year-old Vietnamese potbellied pig was examined because of recurrent ocular discharge and reduced visual ability. Bilateral upper eyelid entropion and impaired vision secondary to periocular fat deposition were diagnosed. Surgical correction with excision of subdermal fat and redundant skin was performed to address both issues. Surgery restored vision and resolved ocular irritation. More than 1 year following surgical therapy the pig is visual and comfortable with no evidence of recurrent fat deposition or entropion.

Entropion correction in dogs and cats using a combination Hotz-Celsus and lateral eyelid wedge resection: results in 311 eyes.

A novel surgical combination technique for the correction of lateral lower lid entropion in dogs and cats is described, involving a combination of Hotz-Celsus and lateral eyelid wedge resection procedures. The technique was used to treat 311 eyes with lower lid entropion: 269 canine (109 bilateral, 51 unilateral) and 42 feline (16 bilateral, 10 unilateral). The most common canine breeds were the Shar Pei, Rottweiler, Bull Mastiff and Labrador Retriever. Domestic cats made up the majority of feline cases. The overall success rate for a single surgical procedure to correct lower lid entropion with this technique was 94.2% per eye.