Several eyelid abnormalities benefit from surgery. Surgery is utilized to correct inherited or acquired conformational abnormalities such as entropion, macroblepharon (excessive eyelid length), ectropion or eyelid agenesis, to remove tumors of the eyelids, or to treat distichiae and ectopic cilia.
What kinds of eyelid issues could my pet have that require surgery?
Entropion is inversion or ‘rolling in’ of the eyelids, leading to contact between eyelid hairs and the cornea. This contact is irritating and uncomfortable, and causes corneal ulceration, scarring, and pain. In contrast to entropion, ectropion is eversion or ‘rolling out’ of the eyelids and is often seen in combination with macroblepharon. Ectropion results in exposure and irritation of the conjunctiva and cornea due to evaporation of the tear film and collection of dust and debris. These conformational abnormalities are most often inherited and can be seen with excessive eyelid length, weak eyelid cartilage, extensive facial folds, a particular skull conformation, or the anatomy of the orbit.
Distichiae and ectopic cilia are eyelashes arising from hair follicles that are in the wrong location, leading to irritation of the cornea. Distichiasis can be a benign diagnosis if the hairs are soft, but especially in certain breeds with short stout coats the problem can be serious. Ectopic cilia are also more common in certain breeds and cause significant pain and damage to the cornea.
Eyelid masses can have many causes, but tumors and inflammatory swellings are most common. Benign neoplasia (cancer) is most often diagnosed and in the majority of cases complete surgical excision is curative. If surgery is not done correctly with perfect apposition of the surgical margins, chronic corneal irritation and ulceration can result.
How will I know if my pet has an eyelid problem?
Signs of a problem can be variable and include squinting or holding the eye closed, tearing, ocular discharge, swelling, and/or redness. Contact between eyelid hairs or eyelashes and the cornea is painful and the eye will often be very sensitive. Corneal changes such as ulceration, cloudiness, or pigmentation may be present. Severe cases can affect vision as well. Eyelid masses can be small or large and can sometimes also cause corneal irritation. They may be within the eyelid or growing from the eyelid margin or skin surface.
What types of eyelid surgeries are performed?
Surgery is catered to the specific eyelid issue of the patient. Treatment of entropion and ectropion depends on the cause and the age of the animal, but generally the goal is correcting the inversion or eversion to allow the eyelids to lie flat against the globe. Because eyelid length is often seen in conjunction with entropion and ectropion, eyelid shortening may be combined with these procedures.
Distichiae and ectopic cilia are treated with removal of the offending hairs and destruction of the hair follicle to prevent re-growth.
Eyelid mass removal surgery depends on the size and location of the lesion. Small masses can be removed more easily, while larger masses require a more complicated procedure. The most important concept with any eyelid surgery is to provide your pet with a functional, comfortable eyelid.