canis - Articles
Trichiasis
Introduction
- Cause: normal facial hair (usually from the eyelid) is abnormally angled so that it contacts the cornea.
- Often seen in the elderly English Cocker Spaniel English Cocker Spaniel in association with atonic entropion Entropion , and in brachycephalics with prominent nasal folds.
- Can also result from eyelid scarring → lid distortion.
- Signs: red eye, ocular pain, excessive lacrimation, corneal ulceration.
- Diagnosis: history, breed, clinical signs.
- Treatment: surgery.
- Prognosis: good/fair.
Presenting signs
- Red eye.
- Ocular pain.
- Excessive lacrimation.
- Corneal ulceration Ulcerative keratitis.
Age predisposition
- >7 years.
Breed/Species predisposition
- English Cocker Spaniel English Cocker Spaniel.
- Brachycephalics.
Cost considerations
- Simple surgical correction.
- Offending hairs may be flattened with routine use of petroleum jelly to prevent corneal contact.
Pathogenesis
Etiology
- Inherited disease.
- Prominent nasal folds.
- Atonic entropion Entropion.
- Iatrogenic (previous eyelid surgery causing lid distortion) → scarring.
- Eyelid injury → scarring.
- Masses on eyelids.
Predisposing factors
General- Prominent nasal folds in pugs, Pekingese and Bulldogs.
- Medial canthal trichiasis in brachycephalics.
Pathophysiology
- Elderly English Cocker Spaniel: decreased elasticity in the skin on the top of the head → slipping of the palpebral fissures → upper eyelid hairs contact the cornea, ie entropion Entropion.
- Brachycephalics: prominent nasal folds → corneal irritation → superficial keratitis (often pigmentary).
- Cicatricial: previous eyelid scarring (often iatrogenic) → lid distortion → trichiasis.
- Brachycephalics: medial central trichiasis → corneal irritation → epiphora.
- Abnormally positioned skin hairs induce corneal epithelial injury to result in corneal ulceration, vascularization and corneal pigmentation.
- Blepharospasm and tearing may also occur.
Timecourse
- Nasal fold trichiasis may be asymptomatic, cause only pigmentation of the cornea, or can result in severe keratitis.
- Nasal fold induced changes can be chronic to rapid.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Bedford P G C (1988) Conditions of the eyelids in the dog. JSAP 29 (7), 416-428 VetMedResource.
- Stades F C & Boeve M H (1987) Surgical correction of upper eyelid trichiasis - entropion - results and follow up in 55 cases. JAAHA 23 (6), 607-10 AGRIS FAO.