348 Veterinary Medicine. 



This failing, Gaillard's sutures may succeed. With a pair of 

 forceps with looped, transversely elongated blades, pinch up skin 

 and muscle sufficient to correct the entropion, and passing a 

 needle twice through this fold with an interval of 3mm., tie 

 the suture over a small roll of cotton. The stitches may be re- 

 moved in two days and the cicatrices may permanently obviate 

 the deformity. 



The older plastic operation is more trustworthy : The skin of 

 the affected lid is pinched up to such an extent in length and 

 breadth, as to correct the entropion and is then excised with 

 sharp scissors or bistuory so as to leave a long elliptical sore. 

 The edges of this are then carefully sutured together and the re- 

 sulting union corrects deformity. Frbhner excises a circular 

 piece of skin and allows it to contract and heal by granulation. 

 In case the entropion is caused by an old standing cicatrix, it may 

 be necessary, first, to make a careful incision along the edge of 

 the lid so as to separate the tarsus and conjunctiva from the cilia 

 and Meibomian ducts, and then to proceed with the plastic oper- 

 ation on the skin. 



TURNING OUT OF THE EYEWD. ECTROPION. 



In large dogs, in old age, debility, conjunctival swelling, cicatrized skitb 

 of lids, distortions of lids. Symptoms : exposure of pelpebral mucosa, 

 weeping eyes, conjunctival hypertrophy (chemosis). Treatment: scarify 

 or excise a fold of mucosa, astringent antiseptics, Snellen's suture, Diefen- 

 bach's operation, Wharton Junes operation. 



This is much more common than entropion, but much less in- 

 jurious as the tarsi and lashes do not irritate the conjunctiva. It 

 is especially common in large dogs (hounds, mastiff) and usually 

 afEects the inner part of the lower lid. Old age and debility con- 

 tribute materially to the condition, the lack of tone or paresis 

 being an important factor. It may, however, occur in any ani- 

 mal, from conjunctivitis and swelling of the mucosa, from cica- 

 trices or old standing disease of the skin of the eyelids, or from 

 imperfectly healed wounds leaving distortions of the lower lid. 

 It is most frequent in the lower lid, and the slightest pendulous 

 condition, which detaches the tarsus from the bulb, and exposes- 

 a narrow zone of the conjunctiva is considered to be an ectropion. 



