ENTROPION— TUBNINO IN OF THE EYELID. 351 



Clinical Symptoms. As a rule, the inversion of the lid occurs 

 more frequently in the upper than the lower eyelid, but we may 

 also see both affected at the same time. Sometimes we see a lateral 

 inversion of the eyelid. This is extremely rare, however. A symp 

 torn observed is constant irritation, which is caused by the hair of 

 the lashes being directed toward the cornea. We also see a marked 

 lachrymal secretion, a twitching and convulsive compressing of 

 the eyelids, and a thick, gray mucus accumulates in the corners of 

 the eyes. The hairs of the eyelashes become adherent, and the 

 eyelids may become completely glued together. Besides this we 

 see an intense inflammatory condition of the connective tissue, and 

 in some cases inflammation of the cornea, and in extremely bad 

 cases suppuration. 



Prognosis and Therapeutics. The prognosis may be favor- 

 able when we operate at the proper time, but relapses are not rare, 

 especially in dogs which show a peculiar wrinkled condition of the 

 facial membrane. We may expect a relapse in such cases where 

 we do not entirely remove the conjunctivitis (primary or secondary) 

 at the same time as the entropion. 



It is only in fresh and very mild forms of the disease that we 

 obtain any favorable results by means of medicinal treatment, and 

 this must be directed toward removing the conjunctivitis which 

 exists in conjunction with entropion, otherwise an operation alone 

 will answer. 



The following methods of operation are suggested: 



1. Simple removal of the tumed-vp eyelid by means of scissors. This is 

 undoubtedly the simplest method, but it is very evident that the appear- 

 ance of the animal is very much impaired by it, and that the eyeball may 

 be affected in some manner on account of the insufficient closure of the lid. 



2. Incision of the eyelid in the neighborhood of the internal corner of the eye. 

 This method, which was formerly described by Stellway and recently by 

 Zirin, is not thought by the author to be advisable. This operation con- 

 sists in taking a wedge-shaped piece from the lid through its whole thick- 

 ness. We cannot advise this, however, as we doubt if the lid will become 

 thoroughly united. 



3. Ligation of small portions of cutaneous membrane in different parts of the 

 lid. Stockfieth describes this method in the following manner: We in- 

 troduce a number of needles through the fold of the skin in the eyelid, 

 drawing the portion of skin together by means of a thread in the form of 

 a figure-of-eight. This will act as a ligature. The points of the needle 

 must be cut short, and a small piece of wax put on the ends to prevent 



