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Distichiasis/Ectopic Cilia/Trichiasis 273

(range, 4-21 days) and have been associated Technician Tips least 2 weeks after cessation of signs. Some
with all ML-CDV vaccine strains. • Affected dogs should be isolated from other dogs will continue to shed the virus for up
○ Weimaraners are the most frequently
hospitalized patients, and gowns and gloves
to 2 months after infection.
VetBooks.ir affected breed, and some evidence sug- should be worn by personnel when handling SUGGESTED READING Diseases and Disorders
these patients to prevent transmission of
gests there are familial tendencies. A
glucocorticoid-responsive neutrophilic
disease to other dogs.
meningitis/arteritis has also been described • Transmission by fomites can be devastating; Greene CE, et al: Canine distemper. In Greene CE,
editor: Infectious diseases of the dog and cat, ed 4,
in this breed in association with ML-CDV be sure that nebulization equipment and St. Louis, 2012, Saunders, pp 25-42.
vaccination. The use of a recombinant other objects are thoroughly disinfected AUTHOR: Andy Shores, DVM, MS, PhD, DACVIM
CDV vaccine in young Weimaraners before and after each use. EDITOR: Joseph Taboada, DVM, DACVIM
instead of ML-CDV is suggested. Addi- • In the environment, CDV is very sensitive
tional vaccinations in Weimaraners after to UV light, heat, and drying.
1 year of age have not shown the same
problems. Client Education
• Recombinant CDV vaccines are currently • Vaccination of young dogs is essential.
available and have shown efficacy comparable • Dogs with CDV infections that survive
to ML-CDV vaccines. should be isolated from healthy dogs for at

Distichiasis/Ectopic Cilia/Trichiasis Client Education
Sheet

BASIC INFORMATION RISK FACTORS • Ulcerative keratitis often presents as an oval
Conformation: that follows the path of eyelid movement.
Definition • Brachycephalic: nasal folds Trichiasis:
• Distichiasis: abnormal cilia emerging from • Redundant dorsal skin folds • Congenital: cilia or hair that contacts the
the meibomian gland openings on the cornea; often located on the medial third
eyelid margins of the upper and lower ASSOCIATED DISORDERS of the lower eyelid
eyelids. • Conjunctivitis • Medial canthal: hairs are identified at
• Ectopic cilia: aberrant individual cilia that • Ulcerative keratitis (p. 209) the medial eyelid margin and within the
arise from the meibomian glands and grow • Nonulcerative keratitis (pp. 206 and 212) caruncle, which is aberrant dermis at the
through the palpebral conjunctiva toward Clinical Presentation canthus; corneal pigmentation is often
the cornea. present on the nasal cornea
• Trichiasis: cilia or hairs that arise from normal HISTORY, CHIEF COMPLAINT • Trichiasis is a common finding associated
facial/eyelid skin that are directed toward the Distichiasis: with agenesis of the lateral two-thirds of the
conjunctiva/cornea. • Generally does not produce clinical signs upper eyelid in cats.
unless hairs are coarse or numerous ○ Signs of ocular irritation, such as epiphora
Synonyms • Epiphora and blepharospasm are seen if and blepharospasm, if mild
Aberrant cilia, abnormal eyelashes ocular irritation is present. ○ Keratitis (ulcerative and nonulcerative) if
Ectopic cilia: severe
Epidemiology • Acute signs of severe blepharospasm and
SPECIES, AGE, SEX epiphora Etiology and Pathophysiology
• Common in dogs, rare in cats • Superficial corneal ulceration usually just • Meibomian glands may spontaneously
• Can occur at any age, but most often in dorsal to axial; may be chronic, acute, or develop distichiasis or ectopic cilia if the
young dogs recurring glands become metaplastic.
Trichiasis: • Distichiasis
GENETICS, BREED PREDISPOSITION • Epiphora and blepharospasm ○ Originates from metaplastic meibomian
• Distichiasis: seen in many breeds of dogs, glands and develop secondary to chronic
especially shih tzus, poodles, golden retriev- PHYSICAL EXAM FINDINGS inflammation (meibomitis), emerging
ers, cocker spaniels, and English bulldogs Distichiasis: through meibomian gland openings
• Ectopic cilia: any breed is susceptible but • Single to multiple cilia along the upper/lower located along the lid margin.
common in boxers and shih tzus eyelid margins ○ May or may not contact corneal surface
• Trichiasis • Epiphora, mild conjunctivitis, and nonulcer- • Ectopic cilia
○ Congenital condition seen in English ative keratitis are observed if cilia are causing ○ Originate from metaplastic meibomian
cocker spaniels and in brachycephalic mild ocular irritation; blepharospasm, glands, emerging through the palpebral
small breeds with prominent nasal folds ulcerative keratitis, +/− entropion (secondary/ conjunctiva of the upper eyelid
(e.g., Pekingese, pug) and eyelid coloboma spastic) in severe cases. ○ Always contact the corneal surface
(agenesis) Ectopic cilia: ○ Can occur at any age of the pet’s life
○ Acquired condition seen in breeds with • Commonly observed at the 12-o’clock • Trichiasis
redundant dorsal skin folds (English bull- position (center upper eyelid) ○ Normal hairs that are abnormally directed
dogs, Shar-pei, chow chow, bloodhound, • Observed emanating through the palpebral toward the corneal surface
Saint Bernard) conjunctiva 4-6 mm caudal to the eyelid ○ Congenital trichiasis of the upper eyelid
○ Medial canthal trichiasis: trichiasis of the margin can be bilateral or unilateral.
caruncle is common in brachycephalic • Acute blepharospasm and epiphora are ○ Acquired trichiasis is associated with
breeds typical. redundant skin folds that result in ptosis.

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