An assignment on Eye diseases

(Ectropion, Entropion & Cataract)

Presented by:
Tanvirul Islam
Id:1801124, Reg: 47517
Session: 2017-18

Ectropion
Definition:
Ectropion is a medical condition characterized by the outward turning or sagging of the lower
eyelid, causing the inner surface of the eyelid to be exposed. The disorder can be present in one or
both eyes, but the lower eyelid is more susceptible due to the effect gravitational force. It is very
common in dogs.

Fig: Ectropion In dog

Etiology:
1. Genetic predisposition: Some dog breeds are more prone to developing ectropion due
to inherited anatomical characteristics. Breeds with loose facial skin and droopy features,
such as Bloodhounds, St. Bernards, and Basset Hounds, are commonly affected.
2. Excessive skin laxity: Dogs with excess skin around the face and eyelids are more
susceptible to ectropion. This can be due to genetics, aging, or certain medical conditions.
3. Facial nerve paralysis: Damage or dysfunction of the facial nerve can result in muscle
weakness and laxity, including the muscles responsible for maintaining proper eyelid
position. Facial nerve paralysis can occur due to trauma, infections, or certain neurological
conditions.
4. Scarring or trauma: Injuries to the eyelids or surrounding tissues, such as burns,
surgeries, or trauma, can lead to scarring and subsequent ectropion.
 5. Congenital abnormalities: Some puppies are born with ectropion as a result of
abnormal eyelid development during fetal growth. This is particularly seen in certain
breeds.
Types:
1. Conformational Ectropion: Due to excessive eyelid and facial skin in some breeds.
2. Cicatrical ectropion
3. Ectropion secondary to previous entropion surgery
4. Spastic Ectropion

Clinical signs:
• Outward rolling or drooping of the lower eyelid
• Redness and irritation
• Excessive tearing
• Eye discharge
• Conjunctivitis or eye infections
• Eye dryness

Diagnosis:
Diagnosis is usually made on physical examination. If the dog is older, blood and urine tests may
be performed to search for an underlying cause for the ectropion. Corneal staining will be
performed to assess the cornea and to determine if any corneal ulceration is present.

Treatment:
Repeated, periodic cleansing of the affected eyelid with mild decongestant solutions can control
mild cases.
But in case of established ectropion, the treatment in dogs typically involves surgical correction to
restore the normal position and function of the affected eyelid. The specific surgical technique
used can vary depending on the severity of the ectropion, the underlying cause, and the individual
dog's condition. Here are a few common surgical procedures for treating ectropion in dogs:

• Eyelid wedge resection: This procedure involves removing a small triangular section of
skin and tissue from the affected eyelid. The remaining tissue is then sutured together to
tighten the eyelid and bring it back into its normal position.

• Eyelid shortening: In cases where the eyelid has excess skin or is elongated, the surgeon
may perform a procedure to shorten the eyelid. This involves removing a strip of excess
skin along the length of the eyelid and suturing the remaining edges together.

• Canthoplasty: Canthoplasty is a surgical procedure that involves altering the shape and
position of the lateral canthus, which is the outer corner of the eye where the upper and
 lower eyelids meet. This procedure can help tighten and reposition the eyelid to correct
ectropion.

The surgical correction of ectropion in dogs is typically performed under general anesthesia. After
surgery, post-operative care and follow-up visits will be necessary to monitor the healing process.
Medications such as antibiotic ointments or eye drops need to be prescribed to prevent infection
and promote healing.

Entropion
Definition:
It is characterized by the inward rolling of the eyelid, causing the eyelashes or hair to rub against
the surface of the eye. This condition can occur in one or both eyes and typically affects the lower
eyelid.

Fig: Entropion in Dog

Etiology:
The causes of entropion can be classified into two categories.
A. Primary entropion
B. Secondary Entropion

Primary Entropion: Primary entropion is most detected in puppies and young dogs. It has a
very important genetic component, so it is more common to find it in certain breeds. It is especially
found in breeds that have flat faces and flattened noses, or those with wrinkled faces. Thus, the
breeds with the highest probability of suffering from this disease are Boxer, Rottweiler, Doberman,
Labrador, Hound, Bulldog, Great Dane, Newfoundland.
Secondary Entropion:
Secondary entropion occurs more frequently in older dogs and can affect all breeds of dogs. This
type of entropion usually occurs because of another disease or environmental factors that harm the
dog’s health. The most common causes of secondary entropion in dogs are:
• Blepharospasm (twitching of the eyelids)
• Eye or eyelid trauma
• Chronic inflammation
• Obesity
• Eye infections
• Rapid and marked weight loss

Clinical signs:
The clinical signs those may appear in entropion may include:
➢ Watery eyes and excessive tearing
➢ Eye discharge, which may contain blood or pus
➢ Eyelid visibly rolled inward
➢ Eye irritation
➢ Thickened skin around the eyes
➢ The dog keeps his eyes half open
➢ Blepharospasm
➢ Keratitis (inflammation of the cornea)
➢ Corneal ulcers
➢ Loss of vision (in advanced cases)
➢ Aggression for pain
➢ Sadness and depression

Diagnosis:
The diagnosis of entropion in dogs is typically made through a thorough examination of the dog's
eyes. The dog's medical history should be considered, and a physical examination and close
evaluation of the eyelids and eyes need to be done.
Additional diagnostic tests may be recommended to evaluate the severity of the entropion or to
rule out other eye conditions. These tests may include:
• Fluorescein Staining: This test involves applying a special dye to the eye's surface to detect
any corneal ulcers or abrasions.
• Schirmer Tear Test: This test measures the production of tears to assess tear production
and evaluate if there are any abnormalities in tear production that may be contributing to
the eye irritation.
Treatment:
The treatment of entropion in dogs typically involves surgical correction to address the underlying
eyelid abnormality.

1. Eyelid Tacking: In less severe cases, temporary eyelid tacking may be performed. This
involves temporarily suturing the affected eyelid in a normal position to provide relief and
allow the eye to heal. This procedure is typically done under sedation or local anesthesia.
2. Hotz-Celsus Procedure: This surgical technique involves removing a small section of
skin from the affected eyelid, which tightens the lid and prevents it from rolling inward.
The incision is then sutured back together, allowing the eyelid to assume a normal position.
3. Vertical Canthoplasty: This procedure involves the surgical reconstruction of the eyelid
by removing a small wedge-shaped piece of tissue near the outer corner of the eye. The
remaining tissue is then sutured together, lengthening and repositioning the eyelid.
4. Full-Thickness Eyelid Resection: In severe cases or when other surgical techniques
have been unsuccessful, a full-thickness eyelid resection may be performed. This involves
the removal of a segment of the affected eyelid, followed by suturing the remaining edges
together.

Fig: Dog after the surgery of entropion

Post operative care:

Here are some general guidelines for post-operative care following entropion surgery:
➢ Medications: These may include oral pain medications and antibiotic eye drops or
ointments.
➢ Elizabethan collar
➢ Eye protection: In some cases, applying a lubricating ointment or using a protective eye
shield or goggles to provide additional protection to the eye are needed.
➢ Activity restriction: Avoid activities that could put strain on the healing eyelid, such as
running, jumping, or rough play.
➢ Environmental considerations: Keep the environment clean and free of any potential
irritants.
➢ Regular check-ups.
 ➢ Observation: Monitoring dog closely for any signs of complications, such as excessive
swelling, redness, discharge, or signs of discomfort.

Cataract
Definition:
A cataract is an eye condition characterized by the clouding or opacity of the lens, which is
normally clear. The lens is located behind the iris (the colored part of the eye) and helps focus light
onto the retina at the back of the eye. When a cataract forms, it interferes with the normal passage
of light through the lens, leading to blurred or impaired vision.

Fig: Dog affected with cataract

Etiology:
The cause of cataract includes:
• Genetic inheritance
• Metabolic disturbances
• Trauma
• Nutritional imbalance
• Chronic uveitis
Clinical signs:
The clinical signs of cataracts in dogs can vary depending on the severity and progression of the
condition. Here are some common signs to look out for:
• Cloudy or hazy appearance in the affected eye(s)
• Loss of transparency in the lens
• Difficulty seeing in low light conditions
• Increased sensitivity to bright light
• Changes in behavior or activity level
• Bumping into objects or walls
• Changes in the color of the affected eye(s)

Diagnosis:
The diagnosis of cataracts in dogs is typically made through a comprehensive eye examination.
Here are some common diagnostic methods used for diagnosing cataracts:
• Physical examination
• Ophthalmic examination: Includes,
➢ Slit lamp biomicroscopy: It helps identify the presence, location, and extent
of cataracts.
➢ Direct ophthalmoscopy: This involves using an ophthalmoscope to examine
the back of the eye, including the retina and optic nerve.
• Evaluation of visual function
• Additional diagnostic tests: This includes
➢ Ultrasound imaging: This non-invasive test uses sound waves to create
images of the eye's internal structures.
➢ Electroretinography (ERG): This test measures the electrical responses of
the retina to light stimulation.

Treatment:
There is no non-surgical treatment available for cataracts, the only definitive treatment for
cataracts in dogs is surgery. Here are some common surgical treatments for cataracts in dogs:
1. Phacoemulsification: This is the most common surgical technique used to remove
cataracts in dogs. It involves using ultrasound waves to break up the cloudy lens into tiny
fragments, which are then suctioned out of the eye. After removing the cataract, an artificial
lens called an intraocular lens (IOL) may be implanted to restore vision.
2. Extracapsular Extraction: In cases where phacoemulsification is not suitable, such as
with very advanced cataracts or certain breed-related conditions, extracapsular extraction
may be performed. This technique involves making a larger incision in the eye to remove
 the entire lens along with the cataract. Similar to phacoemulsification, an IOL may be
implanted.
3. Intracapsular Extraction: Intracapsular extraction is less common and typically reserved
for specific cases. It involves removing the entire lens and the surrounding capsule. This
technique requires more advanced surgical skills and may be performed if there are
complications or limitations with the other methods.

Post operative care:

After cataract surgery in dogs, it is important to provide appropriate post-operative care to ensure
proper healing and minimize the risk of complications. Here are some general guidelines for post-
operative care:
Medications: These may include antibiotic and anti-inflammatory eye drops or ointments.
Activity restriction
Elizabethan collar: To prevent your dog from scratching or rubbing the operated eye.
Eye protection: Wearing a protective eye shield or goggles to prevent accidental trauma to the
operated eye.
Environmental considerations: Keeping the environment clean and free of any potential irritants.

References:
1. Veterinary Ophthalmic Surgery, 2nd Edition by Kirk Gelatt, Janice Gelatt,
Caryn Plummer
2. https://www.msdvetmanual.com
3. https://wagwalking.com/condition/entropion
4. https://www.hospitalveterinariglories.com/
5. Class notes and Lectures

END