ECTROPION—TURNING OUT OF THE EYELID 



397 



must be at least 0.5 cm. between the edge of the wound and the edge of 

 the eyelid; the hemorrhage must be completely controlled before the 

 wound is closed with several silk sutures (Fig. 133). Where there is 

 extensive inversion of the lid, it is ])est not to attempt to remove too 

 large a portion of the lid, but divide it into two portions and equalize 

 the tension, as illustrated in the accompanying figure. The portion may 

 be removed either on the upper or lower lid, and also at the lateral 

 corner of the eye a portion in a vertical position can be removed, and in 

 extreme cases of entropion, all three excisions can be performed (Fig. 134). 

 Another method recommended by Schleich consists in removing a piece 

 of skin in the form of an arrow-head (see Fig. 135) and uniting the 

 edges with sutures. 



Fig. 134. 



Fig. 135. 



Fig. 134. — Diagrammatic position of sections and mode of stitching in the operation for entropion. 



(C. Miiller.) 

 Fig. 135. — Diagrammatic position of section in operation of entropion. (Schleich.) 



The simple removal of the inverted eyelid by means of scissors, 



is undoubtedly the simplest method, but it is very evident that not 

 only is the appearance of the animal very much impaired by it, but that 

 the eyeball may be constantly irritated and there is a constant flow of 

 tears on account of the insufficient closure of the lid. 



Tying up small portions of the lid, by means of needles, or the 

 method recommended by Brennen of burning a series of lines on the lid 

 by means of thermo-cautery, which afterward heal and by cicatricial 

 contraction draw the lid back, are not as efficacious as the proceedings 

 first described. 



Ectropion — Turning Out (Eversion) of the Eyelid. 



This condition is, as a rule, in the lower lid, the free edge of the lid 

 being turned out from the eyel)all toward the external side of the eyelid. 

 This is generally noticed in bulldogs, St. Bernards, and setters, especially 

 so in animals that have sunken eyeballs. It may be due to an alteration 



