Eyelid and Third Eyelid

Question 1

Canine eyelid neoplasia basics

Answer 1

Usually benign
Irritation, corneal ulcers
Surgical excision, cryotherapy
Histopath!

Question 2

Types of canine eyelid neoplasia

Answer 2

Meibomian adenoma
Epithelioma
Melanomas
Papillomas
Mast cell tumor

Question 3

Feline eyelid neoplasia basics

Answer 3

Tend to be malignant

Radical excision, chemo, radiation

Question 4

Tyoes of feline eyelid neoplasia

Answer 4

SCC: aggressive locally, ulcerative, will occasionally metastasize, associated with actinic radiation, most prevalent in older white cats
Mast cell tumor
Basal cell carcinoma
Fibrosarcomas

Question 5

Surgical techniques

Answer 5

If less than 1/3 to 1/4 of lid involved, use V or four-sided excision
For larger defects: sliding skin grafts (H plasty), Rotation skin graft, Landolt; Mustarde, sliding z plasty, lip-to-lid
Two layer closure for all but the smallest defects

Question 6

Third eyelid basics

Answer 6

Nictitating membrane
Semilunar fold of conjunctiva in front of globe ventromedially
Support structure is T shaped cartilage
Gland at its base

Question 7

Cherry eye

Answer 7

Young dogs, cockers, bulldogs, other brachycephalics; uncommon in cats (but they occur!)
Pathogenesis
- CT weakness
- Inflammation
- Hypertrophy
Sequelae
- Local irritation
- Chronic inflammation, conjunctivitis
- Ocular discharge
Diminished tear production - dry eye

Question 8

T/F: the meibomian glands produce most of the tears for the eye

Answer 8

False; lacrimal

Question 9

How to fix cherry eye

Answer 9

DO NOT REMOVE THE GLAND
Only medical treatment, 43% develop KCS
Gland replacement (and preservation), 14% develop KCS
Hence, sx is indicated, but potential for KCS (dry eye) persists

Question 10

Cherry eye tx

Answer 10

Conjunctival mucosal techniques
- Envelope (Moore)
- Pocket (Morgan)** most common
Intranictitans tacking
- To TE cartilage
Anterior nictitans anchoring
- To ventral orbital rim
Posterior nictitans anchoring
- To ventral periorbital fascia
- To ventral equatorial sclera
- To ventral oblique muscle
- To ventral rectus muscle

Question 11

Pocket procedure

Answer 11

Two semi-circular incisions of the mucosa at the base of the enlarged and prolapsed gland
Ends of incision do not touch
Undermine conjunctiva to pull over gland
Appose with continuous suture
Tie knots on the anterior face of TE
Nictitans mobile after Sx

Question 12

Bent cartilage

Answer 12

Eversion of shaft of TE cartilage
Large and giant breeds
- GD
- Saint Bernard
- Mastiff
- German Short-haired Pointer
Pathogenesis
- More rapid growth of the posterior (inner) portion of the cartilage compared with the anterior (outer) portion
Sequelae
- Chronic conjunctivitis
Ocular discharge

Question 13

T/F: Third eyelid neoplasia is more common in dogs than cats and horses/cows

Answer 13

False; more common in cats and horses/cows

• Adenomas/adenocarcinomas
• Papillomas
• Hemangiomas/hemangiosarcoma
• Lymphosarcoma
• Melanoma
• SCC