The conjunctival crypt of the equine third eyelid

The purpose of this study is to characterise the gross anatomy of a relatively large, cryptic structure within the bulbar conjunctival surface of the equine third eyelid that has commonly been observed by the authors during equine ophthalmic examinations. In this study, cadaveric eyes and adnexa were obtained from 13 Quarter Horses without history of ocular disease. The gross anatomy of the bulbar surface of the third eyelid was characterised by digital macrophotography and with an image capture system using an operating microscope. A well-defined cryptic structure was readily identified in the majority of eyes (17/26). The location of the crypt varied but was most commonly observed within the central aspect of the bulbar surface of the third eyelid, often in close proximity to prominent blood vessels oriented perpendicular to the leading edge of the third eyelid. A patch of lymphoid follicles was often observed surrounding the crypt. The rectangular shape and upward facing orientation of the crypt was akin to a shirt's breast pocket. Width and depth were variable but ranged between 1 and 8 mm in either dimension. Some crypts were complex, with multiple channels observed within the primary opening. In conclusion, this study confirms the presence of a well-organised mucosal crypt within the bulbar surface of the equine third eyelid capable of harbouring foreign material and ocular irritants. Additional anatomical characterisation of the macro-crypt by light microscopy, immunohistochemistry and electron microscopy is underway. Evaluation of this structure by equine practitioners and veterinary ophthalmologists should be performed during the routine ophthalmic examination to better understand its role in ocular disease.     

Bilateral intraocular glandular choristomas in a Thoroughbred foal

Intraocular choristomas are rare anomalies in domestic animals and are often associated with multiple ocular malformations. A Thoroughbred foal presented for ocular abnormalities and was diagnosed with microphthalmia, corneal dermoids, severe anterior segment dysgenesis (including glandular choristomas), aphakia, retinal dysplasia, and optic nerve hypoplasia. Morphological, histochemical, and immunohistochemical comparisons were made between ocular choristomatous tissues from this foal and lacrimal gland, third eyelid gland, nasopharynx, trachea, and lacrimal sac/nasolacrimal duct from normal horses. Morphologically the choristomatous tissues (glands and epithelium lining the anterior segment) were most similar to the lacrimal sac. Histochemistry of glandular components found the glands associated with the lacrimal sac/nasolacrimal duct to be serous, as was the glandular intraocular choristomas. Our findings suggest that the origin of intraocular glandular choristomas in this case is from the lacrimal sac.     

Evidence for papillomaviruses in ocular lesions in cattle

Negatively stained preparations of various ocular lesions, generally considered to be precursors to bovine ocular squamous cell carcinoma, were subjected to electron microscopic examination for viruses. Lesions examined included five conjunctival plaques, an acanthotic lesion from an eyelid, 15 conjunctival papillomas, two papillomas of the eyelid and two keratinised elongated proliferative lesions of the eyelid (cutaneous horns). Eight lesions contained particles that resembled papillomaviruses. These consisted of a conjunctival plaque, five conjunctival papillomas, a papilloma of the eyelid and one of the samples of cutaneous horn. The particles were present in small numbers and were found only after prolonged search. The finding of these particles suggests that papillomavirus may be involved in the aetiology of bovine ocular squamous cell carcinoma.     

Canine amniotic membrane transplantation for corneal reconstruction after the excision of dermoids in dogs

Transplantation of canine amniotic membrane (AM) in conjunction with a third eyelid flap was performed after the removal of large dermoids by keratectomy and conjunctivectomy on 7 eyes of 7 dogs. Corneal epithelialization was completed within 2 weeks after the transplantation. Five eyes attained normal transparency of the cornea within 5 weeks. Slight pigmentation of the bulbar conjunctiva at the limbus was observed in 1 dog that had pre-existing pigmentary keratitis. Neovascularization and scarring of the cornea and impaired vision were not found in any dogs at 8 weeks after the transplantation. In conclusion, transplantation of canine AM can promote corneal healing after the excision of large dermoids in dogs.     

Common ocular problems of Shin Tzu dogs

In recent years the Shih Tzu has become a popular breed of dog. It has a number of serious diseases of the eye which are not being recognized by breeders, owners, and sometimes veterinarians. The purpose of this communication is to assist veterinarians in recognizing and treating, where possible, some of the common ocular problems of this breed, including medial canthal entropion, various trichiasis problems, dermoids, third eyelid gland prolapse, chronic keratitis and corneal ulcers, progressive retinal atrophy, vitreal syneresis, and retinal detachment. Because most of the problems are inherited or of suspected genetic origin, breeders should receive genetic counselling from their veterinarian.     

Morphologic changes of the anterior corneal epithelium caused by third eyelid removal in dogs

Morphologic changes of corneal epithelium after third eyelid removal were observed in six normal Beagle dogs. The observation was conducted on the 17th, 35th and 72nd week after the removal. Morphologic changes were observed on corneal epithelium layers at 17 and 35 weeks post excision of the third eyelid but they were limited to minor changes including abnormal intercellular adhesion and further exfoliation of superficial cells at 72 weeks. The reduced BUT and evidence of vital positive staining correspond with these morphologic changes. Therefore, these changes are thought to be important findings from a morphologic view point in identifying pathologic symptoms of the cornea using clinical evaluation methods such as BUT and vital staining method. Grossly, no clinical indication of ocular disease was indicated by slit-lamp biomicroscopic observation; however, the BUT shortage and positive finding of vital staining indicated that the corneal epithelium layers after third eyelid removal lacked the essential barrier function. Thus, it would seem appropriate to consider that such a condition of the ocular surface would worsen with excessive exposure of the ocular surface, palpebration disorders and other exogenous factors.     

Bilateral corneoconjunctival dermoids and nasal choristomas in a calf

A 5-day-old Angus x Hereford calf presented for bilateral haired masses on the eyes and nasolabial planum since birth. The masses were surgically excised from the inferonasal cornea and bulbar conjunctiva of both eyes and the left and right side of the dorsomedial nasolabial planum. Histopathology of the excised tissue confirmed bilateral corneoconjunctival dermoids with ectopic lacrimal glands, and bilateral nasal choristomas and ectopic nasal glandular tissue. Surgery was curative and healing was uneventful. Bilateral ocular dermoids in combination with nasal choristomas and ectopic glandular tissue have not been documented previously in cattle.     

Ocular abnormalities in healthy Standardbred foals

Objective To determine the prevalence and describe ocular abnormalities in healthy Standardbred foals within 48 h of birth. Animals One hundred and two neonatal foals. Procedures All foals had an unassisted delivery. On the basis of physical examination and the results of hematological and biochemical parameters, all foals were unaffected by systemic diseases. A complete ophthalmic examination was performed within 48 h of birth. Foals with ocular hemorrhages were re‐examined weekly until the abnormalities were resolved. Results 65/102 (63.7%) foals did not show ocular abnormalities, while in 37/102 (36.3%) cases, ocular abnormalities were present. Retinal and subconjunctival hemorrhages were recorded in 19/102 (18.6%), and in 13/102 (12.7%), respectively. In 4/102 (3.9%) animals, an entropion of the lower eyelid was present. Only one foal (1%) showed a congenital nuclear unilateral cataract. No other ocular abnormalities were detected. However, all foals showed various degrees of remnants of hyaloid system. One week after the first ocular examination, retinal hemorrhages had resolved in 100% of the eyes, whereas subconjunctival hemorrhages had disappeared in all eyes by the second week following the first examination. Conclusions The acquired ocular lesions observed with relatively high frequency in the examined healthy Standardbred foals were ocular hemorrhages, which always showed a good outcome. Although these abnormalities were present at birth, they were not considered strictly congenital but likely acquired during parturition. Instead, congenital ocular abnormalities were rarely diagnosed, and the entropion of the lower eyelid was the most common disease in the breed.     

Idiopathic granulomatous disease with ocular adnexal and cutaneous involvement in a dog.

Idiopathic granulomatous disease was the cause of bilateral eyelid masses and additional ocular adnexal disease in a dog. Histologically similar granulomas developed concurrently in distant sites including the limbs, prepuce, and testicles. Periodic resolution and redevelopment of the masses were observed and were unaffected by corticosteroid treatments. Rapid diminution of some of the masses was found after treatment with polyethylene glycol modified L-asparaginase, but poor client compliance and episodes of spontaneous resolution of some of the masses made it difficult to accurately assess effectiveness of treatment. Clinicians should be aware that ocular adnexal granulomas may simulate neoplasms and be a component of a more widespread disease process.     

Hemangiosarcoma and squamous cell carcinoma in the third eyelid of a horse

A 12-year-old Belgian draft horse presented for a right eye third eyelid mass and red-tinged ocular discharge of 3 months' duration. The third eyelid was excised and submitted for histopathology. On histopathologic examination, the mass was composed of both hemangiosarcoma and squamous cell carcinoma. The horse developed thickened eyelids and hemorrhagic ocular discharge from the right eye approximately 16 months following surgery, and was euthanized. Necropsy and histopathology confirmed local recurrence and regional metastasis of the hemangiosarcoma. This was an unusual case because there were two distinct neoplastic processes composing the same mass that could not be differentiated grossly.     

Characterization of membranous (M) cells in normal feline conjunctiva-associated lymphoid tissue (CALT)

Objective To characterize conjunctival lymphoid nodules obtained from the nictitans of healthy cats to determine if the follicle‐associated epithelium (FAE) of conjunctiva‐associated lymphoid tissue (CALT) in this species contains membranous (M)‐cells analogous to those described in other regions of mucosa‐associated lymphoid tissue (MALT). Methods Lymphoid follicles from nictitan bulbar surfaces of 10 healthy cats (20 eyes total) were examined. Nictitans from five cats were harvested immediately post‐mortem and a minimum of 12 lymphoid nodules from each third eyelid were isolated using a Zeiss operating microscope. At least three lymphoid follicles from each eye were examined using light microscopy (LM), transmission electron microscopy (TEM), and scanning electron microscopy (SEM) using standard fixation and embedding protocols. Nictitan‐lymphoid follicles from another five healthy cats were processed for immunohistochemistry to characterize the distribution of T‐ and B‐lymphocytes present beneath the FAE. Results The FAE overlying CALT from 10 healthy cats demonstrated morphology characteristic of M‐cells including attenuated apical cell surface with blunted microvilli and microfolds, invaginated basolateral membrane forming a cytoplasmic pocket, and diminished distance between the apical and pocket membrane. Immunohistochemistry of lymphoid tissue subtending the FAE demonstrated B‐cell dependent regions in the germinal centers surrounded by T‐cell dependent interfollicular zones. Conclusions Healthy feline CALT contains morphologic features analogous to those described in other regions of MALT. Documentation of feline conjunctival M‐cells is of clinical relevance in the study of primary infectious, allergic, and autoimmune ocular diseases, as well as a potential means of vaccination or drug delivery.     

Surgical management of bilateral,upper and lower eyelid entropion in 27 Shar Pei dogs,using the Stades forced granulation procedure of the upper eyelid only

ABSTRACT

Aims: To evaluate the outcome of surgical management of entropion of the upper and lower eyelids in Shar Pei dogs which had previously undergone temporary palpebral tacking, using the Stades forced granulation procedure of the upper eyelid only.

Methods: Medical records were retrospectively searched to identify Shar Pei dogs referred for bilateral entropion of both the lower and upper eyelids, and that were treated with the forced granulation procedure of the upper eyelid only. Dogs were included if they had previously undergone unsuccessful temporary palpebral tacking and had at least three follow-up examinations in the 30 days following surgery.

Results: Twenty-seven Shar Pei dogs with a median age of 7.9 (min 4, max 24) months were included in the study. Before surgery, all dogs showed signs of severe ocular discomfort with bilateral keratitis and visual deficit due to blepharospasm, enophthalmos and protrusion of the third eyelid. In 13/54 eyes, keratitis was associated with a corneal ulcer. When re-examined 4 weeks after surgery, correction of the upper eyelid entropion and associated trichiasis resolved ocular signs in 50/54 eyes. Mild bilateral lower entropion remained in two dogs postoperatively, which underwent revision surgery with the Hotz-Celsus technique. There were no cases of long-term recurrence of entropion or ocular irritation in the 38 eyes (19 dogs) which were re-examined 1 year after surgery.

Conclusion and clinical relevance: The forced granulation procedure performed on the upper eyelid only was effective for correction of entropion in the Shar Pei dogs included in this study. In our experience, it is preferable to operate on the upper eyelid alone, rather than attempting to correct upper and lower entropion during the same surgical operation. The dog can then be reassessed a few weeks later to determine whether the lower entropion is anatomical or secondary to the severe blepharospasm resulting from the painful ocular irritation.     

Mucosa-associated lymphoid tissue lymphoma of the third eyelid conjunctiva in a dog

A 4-year-old, neutered female Cocker Spaniel was presented to the veterinary clinic for protrusion of the left third eyelid. When the third eyelids from both eyes were everted, lobulated masses were present on the bulbar surface. The left third eyelid had a larger protrusion. There was no apparent associated ocular or systemic involvement. The tumor of left third eyelid was removed and referred for histological examination. Histologically, there were proliferations of lymphoid follicles surrounded by lymphoid cells forming a marginal zone. Those lymphoid cells occasionally infiltrated into conjunctival epithelium. A few apoptotic bodies with karyopyknotic and karyorrhexic nuclei were observed in the germinal center of lymphoid follicles. Mitotic figures were rare. On immunohistochemistry, tumor cells expressed CD79a but not CD3. A diagnosis of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) of the third eyelid was established based on the histological and immunophenotypical features. At the 1-year follow-up, there was no evidence of recurrence of the mass at the area of excision of the left third eyelid and the remaining tumor of the right third eyelid was still a similar size. The dog still showed no significant findings, except those of the tumor, and no evidence of systemic involvement. To the authors' knowledge, this is the first reported case of MALT lymphoma of the third eyelid in a dog.     

Ophthalmic examination and conjunctival bacteriologic culture results from a herd of North American bison.

OBJECTIVE: To establish ocular characteristics, determine nature and prevalence of ocular lesions, and identify representative bacterial flora from the conjunctiva of North American bison (Bison bison). DESIGN: Prospective study. ANIMALS: 63 bison; 45 males and 18 females. PROCEDURE: Ophthalmic examinations were performed on 1 group of 38 bison in December 1997 and on a second group of 25 in March 1998. Eyes were examined with a penlight, magnification loop, and indirect ophthalmoscope. Two culture swabs were used to obtain samples from the inferior conjunctival sac. One swab was submitted for isolation of bacteria and the second was submitted for isolation of Mycoplasma organisms. RESULTS: 15 ocular abnormalities were observed in 13 of the 63 bison. These included minor ocular discharge in 5 animals, 1 eyelid laceration, 1 periocular Demodex spp infection, 6 corneal abnormalities, 1 anterior synechia, and 1 cataract. Seventeen species of bacteria were isolated from the 63 swabs submitted for culture. The most prevalent bacteria were of the genus Bacillus (74.6%). Mycoplasma organisms were not observed. CONCLUSIONS AND CLINICAL RELEVANCE: Corneal abnormalities were the most frequently identified ocular lesions in bison. Bacterial flora of the conjunctiva and ocular characteristics were similar to those reported for cattle.     

Conjunctiva-associated lymphoid tissue (CALT) in normal and Bordetella avium-infected turkeys

Conjunctiva-associated lymphoid tissue (CALT) was characterized in normal and Bordetella avium-infected turkey poults during the first 5 weeks of life. At 1, 5, 12, 19, 25, and 33 days post-hatching (DPH), upper and lower eyelids were examined by gross, histologic, and electron microscopic techniques. CALT was confined to the proximal part of the lower eyelid near the conjunctival fornix; it appeared by 5 DPH as individual lymphoid nodules and as dense masses by 19 DPH. In the upper eyelid, CALT was present only as isolated nodules. Histologically, CALT was composed of dense lymphocyte infiltrates within subepithelial connective tissue, intraepithelial lymphocytes, and flattened lymphoid-associated epithelium that lacked goblet cells. Germinal centers were in CALT by 19 DPH. By scanning electron microscopy, epithelial cells over lymphoid areas were flat and had short, irregular microvilli; non-lymphoid areas were covered by cells with tall, regular microvilli. Transmission electron microscopy revealed that with increasing age of birds, the epithelium over conjunctival lymphoid infiltrates became progressively flattened and infiltrated by lymphocytes. Some blood vessels in CALT had high endothelial cells; lymphocytes were in the lumen and between or beneath endothelial cells. In B. avium-infected poults, CALT was increased, developed earlier, and contained more germinal centers than in normal poults. We conclude that CALT of turkeys closely resembles other mucosal lymphoid tissues and may serve as a site for local antigen uptake.(ABSTRACT TRUNCATED AT 250 WORDS)     

Surgery of the eyelids

Eyelid fit and function are important for maintaining ocular surface health. Some common conditions, which affect these parameters, include abnormal cilia, inappropriate eyelid conformation, eyelid trauma, and neoplasia. When these conditions are associated with discomfort and compromised corneal health, surgical intervention is indicated. The following article reviews common eyelid conditions and recommended surgical techniques for addressing these problems.     

Management of eyelid neoplasms in the dog and cat

Eyelid neoplasms are common in the older dog and typically benign. Eyelid neoplasms in the cat are less common and more often malignant. Resection of eyelid masses may be curative; however, restoration of the eyelid structure after mass excision is essential for maintaining long-term ocular surface health. Surgical techniques and instrumentation for eyelid surgery are reviewed. Indications, benefits. and limitations of sharp excision, cryotherapy, and laser excision and ablation are discussed. Neoplasia of the third eyelid is also discussed.     

Everted third eyelid cartilage in a cat: a case report and literature review

An 8-year-old neutered female British Blue cat was presented with a presumed diagnosis of a prolapsed nictitans gland and associated ocular irritation and epiphora. However, during surgery, the apparent nictitans gland protrusion was determined to be an everted cartilage of the nictitating membrane. The scrolled portion of the cartilage was removed through an incision through the conjunctiva on the bulbar aspect of the third eyelid, as previously described in the dog. This operation resolved the ocular irritation occurring, and the third eyelid returned to its anatomically correct position.     

Ocular onchocercosis in dogs: a review

In recent decades, sporadic cases of ocular Onchocerca species infection have been reported in dogs in the USA and Europe. In the acute stage of the disease severe inflammation of the ocular and periocular tissues was observed. In chronic cases, the strongly coiled, gravid nematodes were incorporated in pea- to bean-sized granulomatous nodules in various parts of the eye, including the retrobulbar space, orbital fascia, eyelid, third palpebra, conjunctiva and sclera. Apart from the ophthalmological significance of the disease, the large number of microfilariae in the skin may be responsible for acute and chronic dermatological problems. The geographical distribution and prevalence of the infection may be greater than currently thought, because the lesions may have been erroneously regarded as other ocular diseases. Onchocerciasis is the world's second most prevalent infectious cause of blindness in human beings and parasitologists have long searched for an experimental model of human onchocerciasis; ocular onchocercosis infections in dogs may provide a useful experimental system.     

Immunotherapy of periocular squamous cell carcinoma with metastasis in a pony.

A 5-year-old Pony of America mare was referred for evaluation of inflamed upper and lower right eyelids. Squamous cell carcinoma of the eyelids and ulcerative keratitis secondary to self-trauma were diagnosed. Initial treatment of the eyelid neoplasia with 2 applications of cryotherapy failed to resolve the lesions, and immunotherapy with bacillus of Calmette-Guerin (BCG) was instituted. Multiple injections of BCG over a 17-week period resulted in progressive shrinkage of the tumor mass, but regional metastasis to the ipsilateral submandibular lymph node occurred. Six months later, ocular neoplastic lesions were not evident, and the lymph node had regressed in size. Eighteen months after the diagnosis of metastatic disease, signs of recurrence were not noticed in either the primary or secondary tumor sites. Squamous cell carcinoma of the equine eyelid historically carries a poor prognosis for resolution. Immunotherapy for equine ocular squamous cell carcinoma should be considered as a treatment alternative to cryosurgery, radiotherapy, hyperthermy, and CO2 laser ablation, especially in cases involving the eyelid.