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Discussion on Surgery for lower eyelid turning inward | |
Author | Message |
Member: Frances |
Posted on Tuesday, Jan 27, 2004 - 8:46 am: Has anyone had this operation? My previous vet could never find a reason for my mare's constantly tearing right eye - said the duct was probably blocked. Flushing the duct never seemed to help much however. The vet I have now says her lower eyelid is turning inward and causing irritation, and that he should be able to correct it with a small operation. (From searching this site I see that the condition is called entropion.)I was just wondering whether there was anything special I should be concerned about, whether the op is routine and unlikely to cause any problems. Might there be a problem with scar tissue afterwards? Thanks for any thoughts/experience. |
Moderator: DrO |
Posted on Wednesday, Jan 28, 2004 - 6:43 am: Yes the surgery is simple and if this is the problem highly effective. I am unsure how you would think scar tissue might be a problem.DrO |
Member: Frances |
Posted on Wednesday, Jan 28, 2004 - 8:01 am: Thanks a lot - that's reassuring. The operation is set for next Tuesday, and will be carried out with a local anaesthetic and sedation. The vet says he'll make a small cut - I've read on the net that it's usually done with a small suture on each end of the lid, though. Does this sound ok to you? And how long do you think she should be off work afterwards? |
Moderator: DrO |
Posted on Thursday, Jan 29, 2004 - 7:07 am: The suture procedure is temporary for entropions that they think will self correct. Permanant correcting requires removing a section of skin to "tighten" the lid and pull it off of the eye. I personally would want the horse layed down to do this but if the vet is comfortable with the horse standing that is OK. Rest till the sutures come out seems sensible to me.DrO |
Member: Frances |
Posted on Thursday, Jan 29, 2004 - 8:04 am: Thank you so much. I'll let you know how it goes! |
Member: Frances |
Posted on Friday, Jan 30, 2004 - 8:36 am: Something else has come up for me to worry about: the vet now wants to do the op with a general anaesthetic (your recommendation, too) at a new equine hospital which is walking distance away.Fine. However, he wants feed and hay withheld from 12 noon on Monday - the op being scheduled for 11.30 - 12 on Tuesday morning. The problem is that my mare has been known to colic when her feed was one hour late - how on earth is she going to manage 24 hours without even hay? This is really worrying me - is there any way around it? I'm thinking of asking if we could make the op a little later in the day so she could at least have hay early the previous p.m. - or is there anything I could give her to relax her and prevent an anxiety colic? I'd really appreciate your opinion (as ever). |
Member: Kthorse |
Posted on Friday, Jan 30, 2004 - 9:35 am: I am not a vet, but if they say no food 24 hours prior to surgery ,you must follow instructions. People also cant eat prior to surgery it can cause major complications. Even if you gave her hay in the evening you would have to wait 24 hours meaning she would have to have surgery in the evening also. Your horse needs 24 hours of no food. Are you sure the reason your horse colicked was because dinner was late? I would also let your vet know of your concerns about colic. Maybe he can put your mind at ease. Wishing you and your horse well. Good luck with the surgery.Katrina |
Member: Christos |
Posted on Friday, Jan 30, 2004 - 3:08 pm: Lynn,You must consult your vet, he may administer something to calm her down during her diet hours. The problem with food during full anesthesia is the weight of a full bowel. It presses very hard on the diaphragm, reducing lung efficiency and arterial oxygenation. Food in the bowel may also ferment due to decreased mobility and result in colic, or, in the case of grass consumption, a horrible bloat during the operation. I'd suggest you don't cheat on this out of sympathy for the hungry baby. |
Member: Frances |
Posted on Saturday, Jan 31, 2004 - 12:31 pm: Katrina and Christos: Thanks a lot to you both for your input. I wasn't of course planning to cheat on the 24-hour starvation requirement - just worried about the effect on my rather neurotic mare. At the moment I feel as if what seemed to be a straightforward solution to a runny eye is becoming far more hazardous than the condition it's meant to cure, since general anaesthesia is also slightly risky. I'm not absolutely sure, Katrina, that a late meal was the reason for the previous colic, but it seemed the only explanation at the time. And I will ask the vet, Christos, if there's anything I can give her to see her through her 24-hour fast. I'm also asking him if perhaps we could revert to his initial idea of local anaesthetic & a stronger sedation, rather than a general knockout.Thanks again! |
Moderator: DrO |
Posted on Saturday, Jan 31, 2004 - 6:26 pm: You can make the request but having a scalpel blade significantly less than a centimeter from the eye is pretty scary unless the horse is knocked out. You can only sedate so much before they become unsteady.DrO |
Member: Frances |
Posted on Monday, Feb 2, 2004 - 6:15 am: Yes, you're right DrO. She's going to be knocked out (on Wednesday now), and the vet says she can't have anything to calm her during her fast, so ... she'll have to go cold turkey. If she colics we'll treat the colic and abort the op, then try again in a week or two I guess. I asked if the op was really necessary, and the vet said my mare would be at risk of losing the eye to infection in a year or so without it, so at least I feel the risks are worth it. It's certainly not a happy eye at present anyway.Many many thanks for all the advice. |
Member: Frances |
Posted on Thursday, Feb 19, 2004 - 9:29 am: An update: mare survived starvation and operation brilliantly - was so sweet and cooperative throughout. Eye healed well, didn't run at all - stitches came out last Sunday. Next day the eye, which had stayed dry ever since the op, started to run again, though not much. Do you think there's a problem, or is it normal for a little tearing to show up for a while? The vet didn't remove a section of the eyelid, but cut "a moon shape" as he put it. (Just to add to my "happiness", the mare was lame this a.m. - almost like a tying-up, but the vet said she must have got cast in her box overnight for a long time, making all the muscles on her right sore. She's never been cast before to my knowledge, but there's a first time for everything I suppose.) |
Moderator: DrO |
Posted on Friday, Feb 20, 2004 - 7:13 am: If you are having unexpected problems you should consult your vet Lynn but I would not expect the eye to instantly become trouble free, it has some healing to do.DrO |
Member: Frances |
Posted on Monday, Mar 15, 2004 - 11:30 am: It's now a month on, and the eye is tearing as much as it did before the op. The eyelid does not look turned in, but actually quite baggy, which I feel leaves it exposed to dust and cold wind (which we're having a lot of). After I wipe it clean, it temporarily looks a lot better and even seems to close up . The strange thing is that, as I mentioned before, there was no tearing whatsoever until the stitches were removed - the blinker she was wearing was removed at the same time, though, so it was the first time the eye had been unprotected, and possibly that was the cause, rather than the sutures' removal. The vet can't understand why the eye should still be running - he tried flushing the tear duct, and it took a little while for the saline to emerge from the eye but eventually did - but it hasn't made any difference.What I can't help feeling is that the entropion has been surgically converted to an ectropion. The vet did not follow the procedure you described, DrO, but cut a crescent shape. If the (lower) eyelid is in fact turned out too far now, is there anything short of more surgery that can be done? I was wondering about the small-suture- at-each-end-of-the-lid procedure which you said was to correct a temporary entropion - could that equally well tighten/straighten up an outward-turning lid? |
Moderator: DrO |
Posted on Tuesday, Mar 16, 2004 - 6:52 am: Removing a crescent shaped piece of the offending lid is correct Lynn though the devil is in the details: how big a piece to remove is a judgement call. You may find with time that slight irregularities remodel. Has anyone checked to be sure a suture was not left in?DrO |
Member: Frances |
Posted on Wednesday, Mar 17, 2004 - 10:31 am: Thank you DrO - I'm very glad to hear that the crescent shape was correct. Yes, the vet checked to see if a suture had been left in, but didn't find one. The eyelid was much less "baggy" today, so perhaps as you say time will improve matters; however, the eye was still weeping. Are there any soothing eye DrOps that might help?Thanks again. |
Moderator: DrO |
Posted on Thursday, Mar 18, 2004 - 7:06 am: I am glad to hear the lid is becoming more normal. Does the eye appear painful?DrO |
Member: Frances |
Posted on Thursday, Mar 18, 2004 - 7:42 am: No, it doesn't appear painful, and she's not trying to rub it on anything - it's just running copiously. Slight opaque discharge this morning in the corner of the eye, too, as well as the tears, but this is not always the case. |
Moderator: DrO |
Posted on Friday, Mar 19, 2004 - 7:47 am: If it is tearing copiously I don't think an eye wash necessary.DrO |
Member: Frances |
Posted on Saturday, Mar 20, 2004 - 12:23 pm: Well, I'm just thinking that the eye might have become hypersensitive and therefore be running, and wondered if there was anything soothing that could be introduced. (I agree of course that if the eye is already running it doesn't need eye wash, but ointment tends to end up with dust/shavings stuck to it, so DrOps seemed a better medium.) |
Moderator: DrO |
Posted on Sunday, Mar 21, 2004 - 8:26 am: The most powerful antiinflammatory would be a steroidal opthalmic preparation but DrOps are a bit hard to get in the horses eye. But if the eye is not painful or appear inflammed I am not sure how much help it will be and should be discussed with your vet. I have had good luck with ointments and don't have problems with foreign matter getting in the eyes.DrO |
Member: Frances |
Posted on Tuesday, Mar 23, 2004 - 7:47 am: Thank you - I'll take it up with the vet. |
Member: Frances |
Posted on Tuesday, Apr 6, 2004 - 10:21 am: DrO, looking at the eye in profile from behind I can now see two long lower eyelashes pointing straight up and curving inwards to the eye, sometimes touching, sometimes not. It looks as if this is due to the changed shape of the lower lid after the operation. The vet agrees that this could well be the cause of the continued tearing, and suggests I bring some tweezers tomorrow and pluck them out. (He says they are very slow-growing, so frequent regrowth is not a problem.)Do you agree that eyelashes can be removed safely like this (by me)? |
Member: Annes |
Posted on Tuesday, Apr 6, 2004 - 1:34 pm: Lynn, my mare has the same eyelash problem but with a little different story. I posted in the last month about her severe conjunctivitis which would not clear up completely. I have been treating her now for several months. She did not have the tearing but has some pus in her eye every day and redness. The vet has seen her twice. He did pull out the eyelashes in her lower eyelid that were laying on her eye. (I don't think I'd try that myself.) He believes this irritation may lead to the conjunctivitis or at least, keep it from clearing up. The eyelashes grew back rather quickly though and now he suggests referring her to a clinic 50 miles away that can remove them by laser to get the root so they will not grow back. I am waiting for the vet to call me with more details, cost, etc. and planned to write Dr. O about it when I knew more. We think she had a minor cut to the lower eyelid which left the eyelashes in that position when healed. She is 20 and never had this problem before. It does not seem to bother her. I will be interested in Dr O's comment on this subject too. - Ann |
Member: Frances |
Posted on Tuesday, Apr 6, 2004 - 4:19 pm: Ann, thanks for your reply. It doesn't sound so simple after all to remove eyelashes - I had the feeling it wouldn't be, somehow! Wish I could hang little weights on them to bend them out and down... |
Moderator: DrO |
Posted on Wednesday, Apr 7, 2004 - 6:21 am: Hello Lynn and Ann,As Ann's post suggest this is at best a temporary solution and not one I would try without sedation on most horses. They are not going to stand still while you try to pluck out those lashes. I guess you could look at this as a diagnostic step to see if the tearing stops before contemplating more permanant solutions. DrO |
Member: Frances |
Posted on Friday, Apr 16, 2004 - 6:55 am: Well, horses never cease to amaze me. We finally plucked out the offending eyelashes, and my mare didn't bat an eyelid (sorry!). She didn't even flinch, and seemed to quite enjoy it. However, several days on, the tearing continues, although perhaps is slightly reduced.The lower lid itself has remodelled well, as you said it might DrO, so that's good, but it seems tearing is forever ... |
Member: Pulley |
Posted on Tuesday, Jun 1, 2004 - 3:18 pm: Hello Dr.OI have a 3 week old filly with Entropion. Not sure how long she has had it but the vet looked at her on Saturday and did not see any damage done to the eye. He injected the lower lid with pennecillin (sp?) to swell it and hopefully keep the rolled lid out for a period of time. Talk about trauma for baby & Mom. Worst of it is that within 10 min. after he left it had rolled back in. The vet did tell me I had to roll it back out on my own several times a day but I expected the injection to last longer than 10 min? On top of it all is the fact that I cannot get a hand on this filly now. She use to run to the gate to greet me for her twice daily grooming etc. and is now very fearful. So now it's fast track halter breaking, which I am devastated over, but my main concern is if this manipulation of the eyelid does not work. How soon will I be able to tell if it is not going to stay out on it's own? Assuming I can get the baby caught that is. Obviously it must be cared for or else she could eventually suffer permanant damage to her eye. Surgery only other option? Any suggestions by other members out there regarding this whole halter breaking thing would be greatly appreciated too. Thanks all Lil |
Member: frances |
Posted on Monday, Jun 21, 2010 - 4:42 am: An update on this old thread about my mare's eye op. I can't say it was a resounding success, as she still has a runny eye and the lower lid still bags out slightly.(On the plus side she is an absolute star as far as having ingrowing eyelashes plucked out: I do it without even a headcollar, and then praise her lots and give her a carrot. She seems to feel quite pleased with herself - as she should!) She does get a red inflamed eye, recently as often as every couple of months. I believe it is probably due to the slightly sagging lower lid allowing dust/shavings etc to collect. I having been treating it with a course of antibiotic DrOps (brand name Tobrex here). I don't really like using antibiotics so often though, and am not even sure that the eye is necessarily infected, so I've bought some simpler (I hope) eyeDrOps called Oculosan, made in France, which contain: naphazoline nitrate 0.05 mg/ml zinc sulphate 0.2 mg/ml sodium chloride hamamelis water euphrasia tincture ethanol orange flower oil lavender oil, sodium hyDrOxide 1N or hyDrOchloric acid 1N, water for injections. My idea is to have this product on hand as a first, soothing treatment for eye flare-ups and only to go to the antibiotic as a last resort. DrO, would these ingredients be safe/effective for use in a horse? |
Moderator: DrO |
Posted on Monday, Jun 21, 2010 - 6:58 am: Geez LL, these appear to be anything but simple eyeDrOps. I have no idea if this is safe but the inclusion of ethanol and several botanical oils really makes me wonder. I presume they have been used on others without significant problems....? Concentration here can be everything.If you feel the eye needs rinsing do to the lids morphology trapping dust I would consider simple saline based eye wash solutions that come in multi-use bottles. DrO |
Member: frances |
Posted on Monday, Jun 21, 2010 - 8:01 am: THANK YOU! So glad I checked with you! The pharmacist said they would be simpler, but when I read the ingredients I had to wonder...I can make up my own saline eye wash I guess. Thank you again. |
Member: frances |
Posted on Wednesday, Jun 30, 2010 - 6:50 am: The BO and I have come to the conclusion that my mare has "dry eye", brought about probably by the en(now ek?)tropion as well as dust/wind/sun and all the usual suspects. We've started using artificial tears, which some vets here recommend, as does my (human) optician. The DrOps seem to soothe, cleanse and lubricate her eye and show a lasting benefit. So far no need for antibiotic DrOps. The fact that the artificial tears come in small, one-dose capsules means that I can use them as and when needed without worrying about keeping an opened bottle around too long. I'm very happy with this solution.DrO, I have a question about dosage though: for humans the dose is one DrOp every three-five hours. How does that translate into horse dosage (much larger eye, much larger animal)? Can I use the contents of one capsule, say twice or thrice a day? The brand I'm using is called Vidilac here, made by Bausch & Lomb. Active ingredient is methylhyDrOxypropylcellulose. (Also contains sodium monohyDrOgen phosphate, sodium dihyDrOgen phosphate and sorbitol.) Each capsule contains 0.5 ml. Each ml of solution contains 3.2 mg hyDrOxypropylmethyl cellulose. No doctor's prescription needed. |
Moderator: DrO |
Posted on Wednesday, Jun 30, 2010 - 4:31 pm: LL, without examining the eye and DrOps I don't know what would be a proper dosage. I would suggest that you consult those who have examined your horses eye and recommended the DrOps to you for guidance.In general most eye DrOps put in are about 95% wasted because the surface of the eye will only hold a little bit of extra fluid and the extra is lost as tears so I don't think a larger dose is clearly indicated. DrO |
Member: frances |
Posted on Thursday, Jul 1, 2010 - 6:53 am: Thank you as ever DrO. It was very helpful to hear that "the surface of the eye will only hold a little bit of extra fluid" and that the rest "is lost as tears".In that case I can't overdose her, which was my main concern. Thanks again. |