International Journal of Molecular Veterinary Research
2013,
Vol.3, No.1, 1
-
3
http://ijmvr.sophiapublisher.com
2
Figure 1 Prolapsed third eyelid in dog (Cockerel Spaniel)
gland was replaced back to its original position
(
Figure 2). Then patient was medicated topically with
eye drops (Mebradex®, MediPak, Pakistan) to keep
the eye surface wet and reduce the chances of
inflammation and infection. The animal was
monitored for recurrence and there was no recurrence
up to 3 months post treatment.
Figure 2 Reduced prolapse of third eyelid after application of
massage method
Discussion
Third eyelid covers the medial canthus of the eye,
consists of T-shaped flap like cartilage and tear gland,
both are helpful in protection of eye (2). Prolapsed
gland appeared as a dark pink to reddish mass and
misdiagnosed as a tumor and treated like a tumor in
which gland was excised out, but this resulted in
dryness of the eye because third eyelid gland or
nictitating gland is one of the tear producing glands
that keeps the eye moist. The main complication after
its removal was kerato-conjunctivitis siccas (KCS)
(
Gelatt, 1999). Third eyelid gland produces 30% of
the total tears (Gellat, 1991; Saito et al., 2001) which
are important for the intactness of eyelid, eyeball
surface and conjunctiva (Davidson and Kuonen, 2004).
This prolapse happens because of the loss of tensile
strength of the peri-orbital supporting ligament that
anchors the gland to the peri-orbit (Mitchel, 2012).
So the prolapsed gland becomes exposed to the
external environment which leads to increase in the
glandular size due to abrasion and drying (Moore,
1998;
Gellat, 1991).
Regarding its treatment, two methods are usually
adopted; excision of gland and replacement of gland.
Excision of gland is an old method and not
recommended now-a-days because the whole gland is
nipped at its base which leads to 'dry eye’. This causes
further complications. Regarding second option,
cosmetically correction of prolapsed gland is the most
recommended method in which 'tucking' technique is
usually used. Previously single tucking technique was
used but if somehow suture may adhere, this will
cause blepharospasm and visibility of the suture. So
this method is modified now and a wedge of tissue is
removed but how much tissue is removed and tiny
sutures will tightens the gap or not, are the major
points of consideration. Main complications of
modified techniques are inflammation, chances of
recurrence and failure of stitch holding capacity
(
http://marvistavet.com/html/cherry_eye.html
).
The
present case was treated by simple massage method
followed by no recurrence. So it is suggested that the
massage method to replace the prolapsed third eyelid
is considered one of the best and safest methods to
treat the cherry eye condition in dogs if there is no
recurrence.
References
Christmas R.E., 1992, Common ocular problems of Shin Tzu
dogs, The Canadian Veterinary Journal, 33(6): 390-393
PMid:17424020 PMCid:1481255