Ectopic cilia are single or multiple hairs that grow through the inside of the eyelid several millimeters from the lid margin, and rub on the cornea. Ectopic cilia most commonly occur in the middle of the upper eyelid. The problem is more common in dogs than cats and most often affects young dogs. Ectopic cilia can be seen in any breed, although it appears to be more common in the
dachshund, Lhasa apso, Shetland sheepdog,
shih tzu,
golden retriever, English
bulldog, Boston terrier and pug.
General Causes Similar to distichiasis, a hair follicle forms in the base of one of the glands in the eyelid rather than on the skin side of the eyelid. As the hair grows, however, it does not exit from the opening of the gland, but rather it breaks through the inner surface of the eyelid. After it breaks through the conjunctiva it lies directly on top of the cornea.
An inherited breed predisposition occurs in some dogs.
The cause may be unknown when the cilia occur in an unusual breed.
What to Watch For
Although the glands from which the hair arises are usually present at birth, the problem may not be evident until cilia grow through the conjunctival surface.
Ocular pain with severe squinting
Tearing or mucous discharge from the eye
Pawing at the eye
Clouding of the cornea
Inability to see the cornea well because the third eyelid is covering it
Superficial ulceration in the uppermost quadrant of the central cornea, which lies opposite where the hair exits the eyelid
Diagnosis
The occurrence of a superficial corneal ulcer in the top half of the cornea in a dog less than one year of age is very suspicious of an ectopic cilia, particularly if other common causes of corneal ulcers are not present.
Identification of the cilia is done via visual inspection of the eye, by everting or turning the eyelid outward and searching the conjunctival side with magnification. The cilia can be very difficult to identify in some dogs because they are fine, light-colored and very small. It is sometimes necessary to refer the dog to a veterinary ophthalmologist for slit lamp biomicroscopy or examination under an operating microscope to identify the cilia if they cannot be seen with routine magnification.
Heavy sedation or anesthesia may be necessary for a thorough examination of the eyelid.
Fluorescein stain uptake on adjacent corneal surface helps identify the position of the cilia.
Treatment
This condition requires surgery to remove the abnormal eyelash, and also medical therapy to treat any associated corneal ulceration.
The most common surgery performed is excision or removal of the eyelash and surrounding conjunctiva. The base of the incision may also be cauterized or frozen with cryotherapy to try and kill any hair follicles that are not visible and to prevent regrowth of the same or new hairs.
The corneal ulcer is usually treated with topical antibiotics and a pupil dilator (atropine) to relieve the dog's pain while the site is healing. Following removal of the eyelash, the corneal ulcer is usually healed within 7 to 10 days.
Home Care and Prevention
Administer all medication as directed by your veterinarian and return for follow-up as directed. The dog is usually monitored for recurrence of the ectopic cilia or development of new ones for 8 to 12 weeks following the surgery.
There is no preventative care for ectopic cilia, but affected dogs should not be bred to dogs with either ectopic cilia or distichiasis.
