Licensed books on medicine
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Inversion of the eyelids may be in all animals, but most often it is observed in dogs. In this disease, the plane of the free edge of the eyelids, which normally adjoins the eyeball evenly, all or for some extent turned inward. With a strong degree of torsion, not only the free edge, but also the skin surface of the eyelid together with the eyelashes is turned to the eye, which causes irritation of the cornea. As a result, keratitis, ulcers develop, and eventually perforation and opening of the anterior chamber occur. Inversion of the eyelids may be on one eye or on both.
Etiology. The disease occurs due to cicatricial conjunctival contraction, cartilage deformity, convulsive contraction of the circular muscle of the eyelids, sagging of the skin of the upper eyelid. Spastic inversion occurs on the basis of chronic inflammatory processes in the conjunctiva and other parts of the eye and at the same time reducing the retractor of the eyeball, due to which the eyeball retracts deep into orbit.
Cicatricial torsion is observed mainly in horses and cattle on the basis of cicatricial conjunctival contractions and in chronic processes in it. In dogs, chronic conjunctivitis, especially follicular disease, is one of the common causes of bloat. Often inversion occurs after the removal of the third century. Pathological changes in the eyeball itself, accompanied by atrophy of it and enophthalmos also cause a reversal of the eyelid. The same should be said regarding congenital anomalies of the eyeball. In all these cases, the edges of the eyelids do not meet sufficient support, and therefore the surface of the edge of the eyelid is drawn inward.
This form of twisting of the eyelids is often observed in horses. Heredity plays a well-known role in the origins of twisting eyelids.
Clinical signs. When inversion occurs, the free (ciliary) edge of the eyelid partially or all over is wrapped inward towards the eyeball. The eye slit is narrowed, there is tearing, conjunctivitis, incorrect position of the edge of the eyelids and eyelashes; in advanced cases, corneal inflammation, clouding and ulceration of it. The eye is drawn into orbit.
Treatment. When torsion of the eyelids, treatment should be aimed at eliminating the underlying cause. With a slight spastic torsion, you can limit the application of the adhesive plaster or strengthen the eyelids in the appropriate position with intradermal sutures. Operative treatment should be considered more reliable, with which it is necessary to hurry, especially if the eyelashes wrapped inside irritate the cornea and conjunctiva. The most common operation for eyelids is to remove a skin fold. The operation is simple. Small animals are fixed on the operating table, large animals are operated in a standing position, under local anesthesia. After preparation of the surgical field, a scalpel is cut out, retreating from the edge of the eyelids by a few millimeters, an oval skin flap of the required size. On the edges of the wound stitched.
Some surgeons leave a wound without seams, allowing the incision edges to come closer through scarring; as a result, there may be an insufficient convergence of the edges or excessive tightening; therefore, suturing is required.
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