OPERATIONS FOR ENTROPION AND ECTROPION 453 



inches from the ligature. The stump is then replaced and 

 retained against straining by packing the vagina with gauze 

 and stitching the vulval orifice. This dressing is removed 

 in twenty-four hours, after which gentle irrigation of the 

 vagina with hot antiseptic solutions once a day completes 

 the treatment. 



Death from shock several hours after the operation, or 

 from peritonitis later, may be anticipated. 



Operations for Entropion and Ectropion. 



These inward or outward deflections of the eyelids are 

 seen chiefly in dogs, the former being the most common. 

 Although generally attributed to cicatrization of pre-existing 

 traumas or inflammations, the cause is usually by no means 

 plain. In fact the abnormality seems to develop inde- 

 pendently of any perceptible lesion. In horses, however, both 

 entropion and ectropion, can always be traced to the cicatri- 

 zation of a definite injury to the eyelids, an incomplete 

 laceration, a through-and-through laceration, a contusion, or 

 a surgical wound necessitated in the ablation of a tumor. 



Operative treatment, the only cure, is indicated as soon 

 as the condition is discovered and should be given before 

 the cornea has sustained serious injury from the inflamma- 

 tion provoked. 



Operation for Entropion.— The operation consists of a 

 simple excision of a section of skin,, of melon-slice shape, with 

 its concavity toward the ciliary border, and about one-quarter 

 of an inch from it, followed by approximation of the edges 

 with interrupted silk sutures. The excision is made adjacent 

 to the most inverted part, the scalpel and thumb forceps being 

 employed for the purpose. The wound thus made must be 

 of sufficient width to bring the lid into slight eversion when 

 drawn together with the sutures, otherwise slight inversion 

 will recur. Failure to entirely correct the inversion may 

 often be turned into success by excising the hair follicles along 

 the most inverted portion. (See Trichiasis, p. 454.) 



Operation for Ectropion.— This operation is not always 

 successful, but usually partially corrects the defect. It is' 

 performed by excising a triangular section of skin adjacent 

 to the everted portion of the lid, and then bringing the two 

 lateral edges together so as to fold up the skin along the base. 

 In addition an elliptical piece of the conjunctiva may be ex- 

 cised. The cicatricial tissue formed during the healing of 

 this peculiar wound builds a support for the flopping eyelid, 



