Entropion
Encyclopedia
Entropion is a medical condition in which the eyelid
(usually the lower lid) folds inward. It is very uncomfortable, as the eyelash
es constantly rub against the cornea
. Entropion is usually caused by genetic
factors and may be congenital. Entropion can also occur secondary to pain of the eye
(leading to self trauma, scarring of the eyelid, or nerve damage.) The upper or lower eyelid can be involved, and one or both eyes may be affected. When entropion occurs in both eyes, this is known as "bilateral entropion." Trachoma
infection may cause scar
ring of the inner eyelid, which may cause entropion. In human cases, this condition is most common to people over 60 years of age.
in which excess skin of the outer lids is removed. Prognosis is excellent if surgery is performed before the cornea is damaged.
Entropion has been documented in most dog
breeds, although there are some breeds (particularly purebred
s) that are more commonly affected than others. These include the Akita, Pug
, Chow Chow
, Shar Pei
, St. Bernard
, Cocker Spaniel, Boxer
, Springer Spaniel
, Labrador Retriever
, Cavalier King Charles Spaniel
, Neapolitan Mastiff
, Bull Mastiff, Great Dane
, Irish Setter
, Shiba Inu
, Rottweiler
, Poodle
and particularly Bloodhound
. The condition is usually present by six months of age. If left untreated, the condition can cause such trauma to the eye that it will require removal.
Entropion has also been seen in cat
breeds. Typically it is secondary to trauma, or infection leading to chronic eye lid changes. It is also seen secondary to enophthalmos
. Congenital cases are also seen with the brachicephalic breeds being over represented.
Upper lid entropion involves the eyelash
es rubbing on the eye, but the lower lid usually has no eyelashes, so little or no hair rubs on the eye. Surgical
correction is used in more severe cases. A number of techniques for surgical correction exist. The Hotz-Celsus technique involves the removal of strip of skin and orbicularis oculi muscle parallel to the affected portion of the lid and then the skin is sutured. Alternative techniqes such as the Wyman technigue focus on tightening the lower eyelid, this technique is not as effective in cases of enophthalmos.
Shar Pei
s, who often are affected as young as two or three weeks old, respond well to temporary eyelid tacking. The entropion is often corrected after three to four weeks, and the sutures are removed.
Eyelid
An eyelid is a thin fold of skin that covers and protects an eye. With the exception of the prepuce and the labia minora, it has the thinnest skin of the whole body. The levator palpebrae superioris muscle retracts the eyelid to "open" the eye. This can be either voluntarily or involuntarily...
(usually the lower lid) folds inward. It is very uncomfortable, as the eyelash
Eyelash
An eyelash or simply lash is one of the hairs that grow at the edge of the eyelid. Eyelashes protect the eye from debris and perform some of the same function as whiskers do on a cat or a mouse in the sense that they are sensitive to being touched, thus providing a warning that an object is near...
es constantly rub against the cornea
Cornea
The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Together with the lens, the cornea refracts light, with the cornea accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is...
. Entropion is usually caused by genetic
Genetics
Genetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
factors and may be congenital. Entropion can also occur secondary to pain of the eye
Human eye
The human eye is an organ which reacts to light for several purposes. As a conscious sense organ, the eye allows vision. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth...
(leading to self trauma, scarring of the eyelid, or nerve damage.) The upper or lower eyelid can be involved, and one or both eyes may be affected. When entropion occurs in both eyes, this is known as "bilateral entropion." Trachoma
Trachoma
Trachoma is an infectious disease causing a characteristic roughening of the inner surface of the eyelids. Also called granular conjunctivitis and Egyptian ophthalmia, it is the leading cause of infectious blindness in the world...
infection may cause scar
Scar
Scars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...
ring of the inner eyelid, which may cause entropion. In human cases, this condition is most common to people over 60 years of age.
Symptoms
Symptoms of entropion include:- Redness and painPainPain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
around the eye - SensitivitySensitivity (human)The sensitivity or insensitivity of a human, often considered with regard to a particular kind of stimulus, is the strength of the feeling it results in, in comparison with the strength of the stimulus...
to lightLightLight or visible light is electromagnetic radiation that is visible to the human eye, and is responsible for the sense of sight. Visible light has wavelength in a range from about 380 nanometres to about 740 nm, with a frequency range of about 405 THz to 790 THz...
and windWindWind is the flow of gases on a large scale. On Earth, wind consists of the bulk movement of air. In outer space, solar wind is the movement of gases or charged particles from the sun through space, while planetary wind is the outgassing of light chemical elements from a planet's atmosphere into space... - Sagging skinSkin-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
around the eye - Epiphora
- Decreased visionVisual perceptionVisual perception is the ability to interpret information and surroundings from the effects of visible light reaching the eye. The resulting perception is also known as eyesight, sight, or vision...
, especially if the corneaCorneaThe cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Together with the lens, the cornea refracts light, with the cornea accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is...
is damaged
Treatment
Treatment is a simple surgerySurgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
in which excess skin of the outer lids is removed. Prognosis is excellent if surgery is performed before the cornea is damaged.
Entropion in other species
Dog
The domestic dog is a domesticated form of the gray wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties. The dog may have been the first animal to be domesticated, and has been the most widely kept working, hunting, and companion animal in...
breeds, although there are some breeds (particularly purebred
Purebred
Purebreds, also called purebreeds, are cultivated varieties or cultivars of an animal species, achieved through the process of selective breeding...
s) that are more commonly affected than others. These include the Akita, Pug
Pug
The pug is a "toy" breed of dog with a wrinkly, short-muzzled face, and curled tail. The breed has a fine, glossy coat that comes in a variety of colors, and a compact square body with well-developed muscle. They have been described as multum in parvo , referring to the pug's personality and...
, Chow Chow
Chow Chow
Chow chow is a breed of dog that was developed in China, where it is referred to as Songshi Quan , which literally means "puffy-lion dog".- Appearance :...
, Shar Pei
Shar Pei
The Shar Pei, or Chinese Shar-Pei, is a breed of dog known for its distinctive features of deep wrinkles and a blue-black tongue. The breed comes from China. The name translates to "sand skin" and refers to the texture of its short, rough coat...
, St. Bernard
St. Bernard (dog)
The St. Bernard is a breed of very large working dog from the Italian and Swiss Alps, originally bred for rescue. The breed has become famous through tales of alpine rescues, as well as for its large size.-Appearance:The St. Bernard is a large dog...
, Cocker Spaniel, Boxer
Boxer (dog)
Developed in Germany, the Boxer is a breed of stocky, medium-sized, short-haired dog. The coat is smooth and fawn or brindled, with or without white markings. Boxers are brachycephalic , and have a square muzzle, mandibular prognathism , very strong jaws and a powerful bite ideal for hanging on to...
, Springer Spaniel
Springer Spaniel
Springer Spaniel refers to two different breeds of dogs, both of which are commonly called simply Springer Spaniel:*English Springer Spaniel*Welsh Springer Spaniel...
, Labrador Retriever
Labrador Retriever
The Labrador Retriever is one of several kinds of retriever, a type of gun dog. A breed characteristic is webbed paws for swimming, useful for the breed's original purpose of retrieving fishing nets. The Labrador is the most popular breed of dog by registered ownership in Canada, the United...
, Cavalier King Charles Spaniel
Cavalier King Charles Spaniel
The Cavalier King Charles Spaniel is a small breed of Spaniel-type dog, and is classed as a toy dog by most kennel clubs. It is one of the most popular breeds in the United Kingdom. Since 2000, it has been growing in popularity in the United States. It is a smaller breed of spaniel, and Cavalier...
, Neapolitan Mastiff
Neapolitan Mastiff
The Neapolitan Mastiff, Italian Mastiff, is a large, ancient dog breed. This massive breed is often used as a guard and defender of family and property due to their protective instincts and their fearsome appearance....
, Bull Mastiff, Great Dane
Great Dane
The Great Dane , also known as German Mastiff or Danish Hound , is a breed of domestic dog known for its giant size...
, Irish Setter
Irish Setter
The Irish Setter , is a setter, a breed of gundog and family dog. The term Irish Setter is commonly used to encompass the show-bred dog recognized by the American Kennel Club as well as the field-bred Red Setter recognised by the Field Dog Stud Book....
, Shiba Inu
Shiba Inu
The is the smallest of the six original and distinct breeds of dog from Japan.A small, agile dog that copes very well with mountainous terrain, the Shiba Inu was originally bred for hunting. It is similar in appearance to the Akita, though much smaller in stature...
, Rottweiler
Rottweiler
The Rottweiler is a medium to large size breed of domestic dog that originated in Rottweil, Germany. The dogs were known as "Rottweil butchers' dogs" because they were used to herd livestock and pull carts laden with butchered meat and other products to market...
, Poodle
Poodle
The Poodle is a breed of dog. The poodle breed is found officially in toy, miniature, and standard sizes, with many coat colors. Originally bred as a type of water dog, the poodle is highly intelligent and skillful in many dog sports, including agility, obedience, tracking, and even herding...
and particularly Bloodhound
Bloodhound
The Bloodhound is a large breed of dog which, while originally bred to hunt deer and wild boar, was later bred specifically to track human beings. It is a scenthound, tracking by smell, as opposed to a sighthound, which tracks using vision. It is famed for its ability to discern human odors even...
. The condition is usually present by six months of age. If left untreated, the condition can cause such trauma to the eye that it will require removal.
Entropion has also been seen in cat
Cat
The cat , also known as the domestic cat or housecat to distinguish it from other felids and felines, is a small, usually furry, domesticated, carnivorous mammal that is valued by humans for its companionship and for its ability to hunt vermin and household pests...
breeds. Typically it is secondary to trauma, or infection leading to chronic eye lid changes. It is also seen secondary to enophthalmos
Enophthalmos
Enophthalmos is the recession of the eyeball within the orbit.It may be a congenital anomaly, or be acquired as a result of trauma , Horner's syndrome, silent sinus syndrome, or phthisis bulbi....
. Congenital cases are also seen with the brachicephalic breeds being over represented.
Upper lid entropion involves the eyelash
Eyelash
An eyelash or simply lash is one of the hairs that grow at the edge of the eyelid. Eyelashes protect the eye from debris and perform some of the same function as whiskers do on a cat or a mouse in the sense that they are sensitive to being touched, thus providing a warning that an object is near...
es rubbing on the eye, but the lower lid usually has no eyelashes, so little or no hair rubs on the eye. Surgical
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
correction is used in more severe cases. A number of techniques for surgical correction exist. The Hotz-Celsus technique involves the removal of strip of skin and orbicularis oculi muscle parallel to the affected portion of the lid and then the skin is sutured. Alternative techniqes such as the Wyman technigue focus on tightening the lower eyelid, this technique is not as effective in cases of enophthalmos.
Shar Pei
Shar Pei
The Shar Pei, or Chinese Shar-Pei, is a breed of dog known for its distinctive features of deep wrinkles and a blue-black tongue. The breed comes from China. The name translates to "sand skin" and refers to the texture of its short, rough coat...
s, who often are affected as young as two or three weeks old, respond well to temporary eyelid tacking. The entropion is often corrected after three to four weeks, and the sutures are removed.
External links
Humans- http://www.kellogg.umich.edu/patientcare/conditions/entropion.html
- http://www.nlm.nih.gov/medlineplus/ency/article/001008.htm
- http://www.upei.ca/~cidd/Diseases/ocular%20disorders/entropion.htm