General Information
Eyelid agenesis is a congenital condition (birth defect) in cats where a portion of the eyelid margin is underdeveloped at birth. This disease of the feline eyelid is also referred to as an “eyelid coloboma”, as a coloboma implies an area of missing tissue. This condition generally affects both eyes and most commonly occurs along the upper and outer aspects of the eyelids. The cause of eyelid agenesis is not fully understood; however, hereditary patterns or in utero viral transmission have been proposed. All cats with eyelid agenesis should receive a thorough ophthalmic examination as additional intraocular abnormalities may be present, which could lead to discomfort or vision impairment.
Treatment Strategies
Eyelid agenesis is generally accompanied by varying degrees of corneal irritation (keratitis) due to hairs rubbing on the cornea or improper tear film distribution leading to corneal drying. These side effects can occasionally lead to corneal ulceration varying from superficial to deep wounds.
Medical Treatment - If the eyelid defect is small, and the cornea is healthy, medical treatment consisting of frequent application of ophthalmic lubricants may be sufficient. The goal of lubrication is to minimize the discomfort of both corneal drying (desiccation) and misdirected hairs, which may touch the corneal surface.
Cryotherapy – The goal of cryotherapy is to freeze and remove misdirected hairs that are causing irritation or ulceration of the cornea. This procedure does not correct the eyelid malformation, but is designed to improve patient comfort, minimize secondary complications of eyelid agenesis, and reduce the amount of topical medications necessary.
Reconstructive Eyelid Surgery – For larger defects, surgical reconstruction of the upper eyelid may be indicated for ocular health and comfort of your cat. There are several surgical methods available, and most are geared at relocating a normal piece of tissue from nearby structures (lower eyelid, lip, etc.) and grafting a “new” eyelid into the defect. The goal of this surgery is to recreate a new eyelid and restore normal function thus providing long-term comfort for your pet.
If a procedure is indicated for your pet, common postoperative care may include the use of short-term systemic antibiotics, anti-inflammatories, and pain medication as well as topical therapy which may include eye drops or eye ointment. An Elizabethan collar should be placed following eyelid surgery to prevent self-trauma. Complications of surgery are uncommon but include wound infection, suture dehiscence, or persistent ocular irritation.
