BASICS
OVERVIEW
Trichiasis develops when hair arising from normal sites contacts the
corneal or conjunctival surfaces. Distichiasis develops when cilia
emerge from or near the meibomian gland orifices on the lid margin.
These cilia may or may not contact the cornea. Ectopic cilia are
single or multiple hairs that arise from the palpebral conjunctival
surface several millimeters from the lid margin, most commonly near
the middle of the superior lid.
SIGNALMENT
• Eyelash disorders are common in dogs and rare in cats.
• Problems tend to occur most commonly in young dogs.
• Any breed can be affected; however, some breeds are
predisposed--breeds with prominent facial folds such as the pekingese,
pug, and bulldog
frequently have facial fold trichiasis; most cocker spaniels have
distichiasis to some degree; ectopic cilia are more common than
average in the dachshund, lhasa apso, and shetland sheepdog, among
other breeds.
SIGNS
Trichiasis
From Facial Folds
• Nasal corneal vascularization and pigmentation
• Blepharospasm
• Epiphora
Distichiasis
• Asymptomatic in most animals.
• If stiff, stout distichia are contacting the cornea,
blepharospasm, epiphora,
corneal vascularization, pigmentation, and ulceration may develop.
Ectopic
Cilia
• Ocular pain
• Severe blepharospasm
• Epiphora
• Often cause superficial corneal ulcers with a linear appearance
(corresponding to lid movement) on the superior cornea. These ulcers
are resistant to healing until the underlying problem is diagnosed and
corrected. |
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CAUSES AND
RISK FACTORS
In most dogs, the disorder is related to facial conformation to breed
predisposition, or it is idiopathic.
DIAGNOSIS
DIFFERENTIAL
DIAGNOSIS
Other adnexal abnormalities (e.g., entropion),
keratoconjunctivitis sicca, conjunctival foreign body, and infectious
conjunctivitis should be ruled out. Diagnosis is made on the basis of
direct observation of the abnormal cilia.
CBC/BIOCHEMISTRY/URINALYSIS
N/A
OTHER
LABORATORY TESTS N/A
IMAGING
N/A
OTHER
DIAGNOSTIC PROCEDURES N/A
TREATMENT
• Trichiasis can be managed conservatively in some animals. Keeping
the periocular hair short may help; however, clipping the hair on
facial folds may make it stiffer and more irritating. Surgical
correction of adnexal abnormalities is indicated, such as entropion
correction. Facial folds can be resected; however, a medial canthal
closure is often a better procedure because it eliminates
lagophthalmos and medial entropion as well as facial fold trichiasis.
• Distichiasis is asymptomatic in most animals, and no treatment is
indicated. When symptomatic, distichia can be treated surgically by
cryotherapy, electrocautery or electroepilation, or resection from the
conjunctival surface. Lid splitting techniques should be avoided
because postoperative scarring can predispose to cicatricial entropion
and impaired lid function.
• Ectopic cilia should be treated surgically with an en-bloc
resection of the cilia and associated meibomian gland. Cryotherapy can
be used as the sole treatment method or as an adjunct after surgical
resection.
MEDICATIONS
DRUGS AND
FLUIDS
• Medical treatment is rarely indicated; however, lubricant
ointments are sometimes valuable when used to soften cilia and lessen
irritation before surgical correction.
• Peri-operative, topically applied antibiotics are recommended in
animals undergoing surgery in an effort to minimize conjunctival flora
in the surgical sites.
CONTRAINDICATIONS/POSSIBLE
INTERACTIONS N/A
FOLLOW-UP
• Regrowth of distichia is common because destructive procedures
such as cryotherapy and electroepilation have to be done
conservatively to minimize lid damage.
• Animals that develop ectopic cilia are at risk for developing
ectopic cilia at other locations.
• Owners should be advised to have their animal rechecked if
clinical signs recur.
MISCELLANEOUS
Reference
Gelatt KN. Veterinary ophthalmology. 2nd ed. Philadelphia: Lea & Febiger, 1991.
Author Erin S. Champagne
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