Conjunctival mucinous adenocarcinoma in an ostrich (Struthio camelus)

A 2‐year‐old male ostrich (Struthio camelus) presented with a rapidly growing soft tissue mass protruding from the ventromedial aspect of the right eye (OD). The initial physical examination revealed a soft tissue mass attached to the medial inferior conjunctiva. The mass was excised with cryosurgery, and the conjunctival tissue margins were treated with cryoablation. Histopathological examination diagnosed granulomatous inflammation associated with scattered acid‐fast bacteria. The ostrich recovered uneventfully and appeared healthy until recurrence of a grossly similar mass 2 months later. Gross examination revealed a botryoid mass attached to the inferior palpebral conjunctiva and extending onto the palpebral aspect of the nictitating membrane. Euthanasia was selected, and the histological diagnosis of the second mass was a mixed mucinous adenocarcinoma; however, no acid‐fast bacteria were seen. Granulomatous conjunctival lesions have been previously described in the ostrich, while, to the authors' knowledge, neoplastic conjunctival lesions have not. Neoplasia should be considered as a differential diagnosis for a rapidly recurring, granulomatous conjunctival mass in this species.     

Bilateral lymphosarcoma of the nictitating membrane in a Quarter Horse

A 21-year-old Quarter Horse mare presented for a mass of the right nictitating membrane. The entire right nictitating membrane was surgically removed and diagnosed as a mixed cell lymphosarcoma and squamous cell carcinoma. The horse had no systemic signs of lymphosarcoma. Approximately 1.5 years later, the horse presented with a similar mass in the left nictitating membrane. The entire left nictitating membrane was surgically removed and diagnosed as a mixed cell lymphosarcoma. In this case, complete surgical removal of the masses resulted in a cure. The horse has remained free of systemic lymphosarcoma for over 3 years.

Case report

A 21-year-old gray Quarter Horse mare was presented to the Kansas State University Veterinary Medical Teaching Hospital for evaluation of a mass involving the right nictitating membrane. The mass was first noticed 5 weeks before presentation and had been treated by the referring veterinarian with a topical steroid solution twice daily. Administration of the topical steroid caused some decrease in the swelling, but it quickly returned once medication was discontinued. The horse had no other medical complaints and appeared to be otherwise healthy. On ocular examination, chemosis of the third eyelid and conjunctiva of the right eye was evident. Direct and indirect pupillary light reflexes, Schirmer tear test, and intraocular pressures were normal in both eyes. Fluorescein stain uptake was negative in both corneas. Cranial nerve and vision examinations did not reveal any abnormalities. On further examination of the right nictitating membrane, a firm mass was palpated under and protruding from the palpebral conjunctiva (Fig 1). No other abnormalities were found on physical examination.     

Evaluation of a soluble sustained-release ophthalmic delivery unit in the dog.

A 5-mg hydroxypropyl cellulose soluble ocular insert was evaluated by placement in the upper and the lower conjunctival and bulbar nictitating membrane fornices in normal dogs. The insert was easily placed in the conjunctival fornices, but was difficult to place in the bulbar nictitating membrane fornix. The conjunctival inserts did not produce irritation of the cornea and the conjunctiva. Placement of the inserts beneath the nictitating membrane produced local irritation and chemosis. The sites of highest to lowest retention for the insert were upper conjunctival fornix, bulbar nictitating membrane fornix, and lastly, lower conjunctival fornix. Dissolution was nearly complete in 8 hours.     

Surgical management of orbital nodular granulomatous episcleritis in a dog

A 27 kg, 6‐year‐old, male castrated German shorthaired pointer presented to the University of Missouri, Veterinary Teaching Hospital with the complaint of progressive exophthalmia of 2 years duration optical density (OD). Lack of retropulsion OD was noted on physical examination. Anterior segment examination OU and fundic examination OS did not reveal any abnormalities. Examination of the fundus OD revealed focal scleral indentation of the inferior nasal globe. The indentation changed location with globe movement OD. MRI and CT scan revealed a well‐circumscribed, approximately 2 cm in diameter mass located caudal and ventral to the affected globe that appeared to communicate with the nictitating membrane with absence of any bony involvement. A modified lateral orbitotomy was recommended and performed to remove the orbital mass and nictitating membrane en‐bloc. Histopathology and immunohistochemistry of the mass confirmed a diagnosis of nodular granulomatous episcleritis (NGE). Postoperatively, the dog developed absolute keratoconjunctivitis sicca (KCS). Examples of primary episcleral inflammation in the dog include diffuse episcleritis, NGE, nodular fasciitis, fibrous histiocytoma, proliferative conjunctivitis/keratoconjunctivitis, pseudotumor, and Collie granuloma. The etiology of these episcleral inflammations is presumed to be immune mediated. To our knowledge, this is the first report of NGE affecting the orbital region of a dog. Development of absolute KCS resulting from excision of the nictitating membrane is also supported by this case.     

Penetrating sclerokeratoplasty and autologous pinnal cartilage and conjunctival grafting to treat a large limbal melanoma in a dog

A four‐year‐old neutered male Labrador retriever presented to Portland Veterinary Specialists Ophthalmology Service for evaluation of a pigmented mass oculus sinister (OS) of approximately 4‐month duration. Complete ophthalmic examination revealed a large, pigmented, raised, well‐demarcated, epibulbar mass appearing to originate from the nasodorsal limbal region. The mass was smooth and roughly circular, extending approximately 4 mm into the sclera and 14 mm into the nasodorsal cornea. Gonioscopy directly under the mass was not possible due to mass size. The visible iridocorneal angle was normal. High‐resolution B‐scan ultrasound showed mass extension to Descemet's membrane and deep sclera, but no intraocular invasion. Penetrating sclerokeratoplasty was performed followed by autologous pinnal cartilage and conjunctival grafting to repair the corneoscleral defect (20 mm x 19 mm) and to restore globe integrity and function. Histopathology confirmed the mass to be a benign limbal melanoma with complete excision. The surgery site healed without complication, and the pinnal cartilage became fully incorporated into the globe. Twelve months postoperatively, the patient remains visual with a normal intraocular and fundic examination. The pinnal harvest site on the right ear healed without complication. To the authors’ knowledge, this is the first reported case of corneoscleral grafting using autologous pinnal cartilage. This may represent a viable alternative to other corneoscleral grafting procedures for large defects and is an attractive treatment option due to lack of host rejection, readily available source of donor cartilage, and provision of tectonic support to the globe.     

Inherited eye disease in the dog and cat

This paper describes the more common inherited eye conditions in the dog and cat, paying particular attention to the newer conditions, not all of which have previously been reported in the literature. These newer conditions include entropion in the shar pei, microphthalmos in the dobermann and miniature schnauzer, cataract in the German shepherd dog and Norwegian buhund, progressive retinal atrophy in the Tibetan terrier, Tibetan spaniel, miniature longhaired dachshund and two forms in the Abyssinian cat, multifocal retinal dysplasia in the English springer spaniel and other breeds, persistent hyperplastic primary vitreous in the Staffordshire bull terrier and dobermann and optic nerve hypoplasia in the toy poodle. Anatomical classification presents a convenient means of describing these conditions which may affect the whole globe, the eyelids, the nictitating membrane, the nasolacrimal duct system, the conjunctiva, the cornea, the aqueous, the iris, the lens and zonule, the vitreous, the retina, the choroid and sclera and the optic nerve.     

CASE REPORT: Medical and surgical management of severe inflammation of the nictitating membrane in a Giant Panda (Ailuropoda melanoleuca)

A 10‐year‐old male giant panda (Ailuropoda melanoleuca) presented for severe, acute swelling and protrusion of the right nictitating membrane, unresponsive to topical therapy. Excisional biopsy of the nictitating membrane and its associated lacrimal gland was elected due to necrosis and friability of the tissue. Histopathology revealed suppurative, necrotizing conjunctivitis and dacryoadenitis. Culture grew Stenotrophomonas maltophila and Enterococcus spp with extensive antibiotic resistance. Treatment with topical and systemic antibiotics based on sensitivity results was initiated. All treatments were well tolerated. Healing was uncomplicated with no recurrence of the lesion and no clinical evidence of keratoconjunctivitis sicca. Ophthalmic exams and Schirmer tear tests performed opportunistically during postoperative anesthetic procedures were unremarkable, confirming that excision of the nictitating membrane had not caused clinically significant detrimental effects. The etiology of this lesion remains undetermined, but trauma is suspected. To the authors’ knowledge, this is the first report of nictitating membrane pathology and excision in the giant panda.     

Dacryops of the lacrimal gland in a dog

A case of congenital lacrimal cyst or dacryops of the lacrimal gland in an 8‐month‐old Neapolitan Mastiff dog is reported. The dog presented with a swelling dorsolateral to the left globe, which had been present since birth. In addition, hyperplasia and prolapse of the superficial gland of the left nictitating membrane, and bilateral macropalpebral fissure and ‘diamond eye’ conformation were apparent. On manual eversion of the upper eyelid, a subconjunctival mass was visible that was translucent and pink and affected the upper conjunctival fornix. B‐mode ultrasonography revealed the presence of an echolucent thin‐walled cystic structure measuring 15 by 12 mm and containing an echodense border and a distended tubular fluid‐filled structure that extended posteriorly. A viscous and transparent fluid was aspirated from the lesion. Surgery was performed to excise the lesion, reposition the nictitans gland, and correct the morphology of the palpebral fissure. Histopathology confirmed the mass to be a cyst and distended duct of the lacrimal gland. Although tear secretion was compromised, resection of the cyst was curative.     

A preliminary study of changes in tear film proteins in the feline eye following nictitating membrane removal

Objective To investigate the influence of nictitating membrane (third eyelid) removal on selected proteins in feline tears. Animal studied Domestic short‐haired cats (7–17 months; 2.6–5.2 kg) were used. Procedures Eye‐flush tears were collected periodically for up to 18 weeks from both eyes of animals with nictitating membranes removed, but nictitating gland left intact, (n = 4) or with nictitating membranes intact (n = 4). Tear comparisons were based on total protein content (TPC) using micro bicinchoninic acid assay, immunoglobulin A (IgA), and matrix‐metalloproteinase (MMP)‐9 measurements using sandwich enzyme‐linked immunosorbent assay (ELISA) and tear gelatinase activity using gelatin zymography. Expression of MMP‐2 and ‐9 in nictitating membranes removed at baseline (week 0) and eyes collected at 18 weeks were also investigated in histological sections using immunoperoxidase for visualization. Results Nictitating membrane removal did not significantly change TPC and MMP‐9 in tears within the first 4 weeks. MMP‐9 was not detected by ELISA in tears from eyes without nictitating membranes from week 5 onwards. IgA (%IgA of TPC) data varied between animals. Gelatin zymography showed increased MMP‐2 and ‐9 activity in tears from eyes without nictitating membranes at week 1 and a decrease following week 2 post‐surgery. MMP‐2 and ‐9 were immunolocalised to conjunctival goblet cells of removed nictitating membranes and to the conjunctival epithelium, respectively. After 18 weeks, the distribution of MMPs in tissue was comparable between eyes with and without nictitating membranes. Conclusions Based on this preliminary study, nictitating membrane removal appeared to cause long‐term changes in expression of tear proteins, including reduced MMP‐9 expression.     

Amniotic membrane transplantation for corneal surface reconstruction after excision of corneolimbal squamous cell carcinomas in nine horses

OBJECTIVE: The purpose of this study was to evaluate the usefulness and effectiveness of permanent amniotic membrane transplantation as an adjunctive treatment to superficial keratectomy alone or combined with strontium-90 irradiation for treatment of equine corneolimbal squamous cell carcinoma (SCC) to decrease corneal scarring and recurrence rate. STUDY: The retrospective case study included 11 horses (n = 12 eyes) diagnosed and treated for ocular SCC that involved the limbus and cornea. Nine of those horses (n = 9 eyes) were treated between 2002 and 2006, with superficial lamellar keratectomy alone or combined with strontium-90 irradiation and followed by placement of a permanent amniotic membrane graft in the surgical defect. The level of scarring (i.e. the clarity of the cornea) resulting with the use of amniotic membrane was subjectively compared to cases where a permanent bulbar conjunctival graft was performed following keratectomy combined with strontium-90 irradiation or cryotherapy (n = 3 eyes). Recurrence was defined as the postoperative and postirradiation regrowth of SCC in the same site and globe. RESULTS: The nine horses that received an amniotic membrane graft after keratectomy alone or combined with irradiation showed a minimal level of scarring in a cornea that regained a greater transparency in comparison to the horses that were treated with a bulbar conjunctival graft. All of the horses that received an amniotic membrane graft had 226 +/- 218 days of follow-up without tumor recurrence (mean +/- SD), ranging from 21 days to 778 days. CONCLUSIONS: The combination of superficial keratectomy alone or associated with beta-irradiation and permanent amniotic membrane transplantation is an effective treatment of corneal or corneolimbal SCC in horses. The placement of an amniotic membrane material represents an alternative surgical procedure to bulbar conjunctival grafts, especially if there is a lack of bulbar conjunctiva tissue available after tumor resection or if a particularly large corneal resection is necessary. The amniotic membrane is incorporated into the corneal defect and seems to create noticeably much less scarring than a corneal defect covered by bulbar conjunctiva.     

Local immune response in the chicken Harderian gland to antigen given by different ocular routes.

The effectiveness of three ocular routes of antigen administration to produce a local immune response in the Harderian gland was studied. The routes were by eyedrop, injection into the ocular conjunctiva and injection into the nictitating membrane. The antigen was observed in the cytoplasm of macrophages located within the lymphoid tissue only after the injection into the nictitating membrane. The numbers of germinal centres and plaque forming cells found in the gland after injection into the nictitating membrane was higher than the numbers observed following the other two ocular applications. These findings indicate that the injection of the antigen into the nictitating membrane is the most effective ocular route for producing a local immune response in the Harderian gland.     

Mast cell tumor invading the cornea in a horse

A 3‐year‐old Marwari mare was presented for evaluation of an irregular, reddish mass protruding from behind the right third eyelid. The mass appeared to arise at the ventral limbal area, involved the perilimbal bulbar conjunctiva and widely extended into corneal tissue. No other ocular or systemic abnormalities were detected at the time of presentation. The mass was surgically removed by lamellar keratectomy, with defocused CO₂ laser used as adjunctive therapy to treat the surgical exposed area and its surroundings. Histopathologic evaluation showed sheets of densely packed, well‐differentiated neoplastic mast cells separated by fibrovascular connective tissue. Nuclear staining for Ki‐67 was performed, and an average of 370 cells were positive per 1000 counted cells. Two months postoperatively, the surgical site was filled with flat fibrovascular and pigmented tissue, while the surrounding cornea was transparent with no superficial vascularization around the fibrotic scar. Thirty‐two months after treatment, no recurrence of the neoplasia was reported.     

Intranictitans tacking for replacement of prolapsed gland of the third eyelid in dogs

Objective  To evaluate a new procedure for fixation of prolapsed nictitans glands to the cartilage of the nictitans that will not interfere with the mobility of the nictitating membrane.
Methods  A prospective clinical trial utilizing a nonabsorbable suture to anchor the prolapsed gland to the cartilage of the third eyelid was undertaken. Fifteen eyes of 10 dogs were included in the study. A 4-0 nylon suture was passed from the anterior surface of the third eyelid through the base of the cartilage to the posterior aspect and then tunneled circumferentially beneath the conjunctiva over and around the prolapsed gland. The suture was then passed through the cartilage again to the anterior face of the third eyelid. The gland was replaced into its normal position as the suture was slowly tightened and then tied on the anterior aspect of the nictitans.
Results  Over a period of several weeks, the glands reduced in size and took on a normal appearance. All glands but one remained in place for the length of follow-up, which ranged from 2 weeks to 33 months.
Conclusions  This procedure results in acceptable cosmetic effects with the return of the gland to its normal position posterior to the nictitating membrane. The advantage of this technique over traditional tacking to the orbital rim is that the third eyelid retains its normal mobility and, thus, its protective functions. The procedure once mastered is very quick and can be performed in less time than many of the traditional replacement techniques.     

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.     

Experimental infection of cats with Chlamydophila felis

Cats experimentally infected with a British isolate of Chlamydophila felis (C. felis), B166 strain, by droplet into the eye and nose developed conjunctivitis, mild rhinitis and fever. The chlamydophila were first isolated from conjunctiva, nictitating membrane and then from lung, tonsil, liver, spleen, kidney, nasal and vaginal swabs and blood. These results indicate that C. felis B166 strain first infected and replicated in the conjunctiva and nictitating membrane in cats with symptoms which were mostly limited to conjunctivitis, and then pervaded the whole body by bacteremia.     

Primary conjunctival mast cell tumor in a Labrador Retriever

A 4-year-old, intact male Labrador Retriever with a rapidly progressive conjunctival mass was evaluated. Ocular examination showed a 2-cm elongated mass arising from the superior bulbar conjunctiva of the left eye. The mass resulted in distortion of the palpebral fissure and contacted the superior aspect of the cornea without modifying its structure; no adhesion to the sclera was detected. The superior palpebral conjunctiva was unaffected, and the remaining ocular examination was normal. The initial diagnostic work-up included CBC, serum biochemical analysis, urinalysis, and fine needle biopsy of the mass. A poorly differentiated mast cell tumor was diagnosed by cytology. Immunocytochemistry was performed to evaluate Ki-67 proliferation index, and 54/1000 tumoral nuclei showed a dark red staining. After a complete clinical staging, the mass was excised and identified histologically as a grade-II mast cell tumor. An adjuvant treatment with prednisone and vinblastine was instituted because of the limited excisional margins. No evidence of local recurrence or metastasis has been apparent during the 29-month follow-up period. This report contributes to the current literature pertaining to canine conjunctival mast cell tumors; unfortunately, the paucity of case reports and the absence of large studies regarding this tumor make conclusions regarding its biologic behavior impossible.     

Amniotic membrane transplantation for the reconstruction of the ocular surface in three cases

This paper describes the use of amniotic membrane in the reconstructive surgical repair of generalized keratomalacia, ankyloblepharon, and after fibrous histiocytoma removal in two dogs and a cat. Case 1 was an 11-year-old female Yorkshire terrier with severe bullous keratomalacia in the left eye (OS). A frozen canine amniotic membrane graft and a third eyelid flap were applied. At day 80 postoperatively, only a mild scar and corneal vascularization were present. Case 2 was a 4-year-old female Siamese cat with symblepharon of both eyes after rhinotracheitis. Resection of the conjunctiva and frozen canine amniotic membrane transplant were performed. One month later, there was a little corneal scarring and corneal vascularization. Case 3 was a 6-year-old female terrier with a scleral and corneal mass at the 11-12 o'clock position (OS). Resection of the mass and amniotic membrane transplantation were performed. The mass was a fibrous histiocytoma localized to the sclera and cornea. This eye healed with mild conjunctivalization and no pigmentation. Amniotic membrane transplantation can be used as a method of reconstruction of the ocular surface with good repair of the cornea and minimal scarring in small animals.     

Corneal hemangiosarcoma in a cat

A 10 year-old castrated male Domestic Short-hair cat with a history of chronic bilateral keratitis was referred for assessment of a red, elevated mass involving the left cornea. The rapid growth of the mass, over a month period in combination with pronounced vascularization and invasion of the corneal surface suggested an aggressive inflammatory or neoplastic process. Following keratectomy, the lesion was diagnosed histopathologically as a hemangiosarcoma. The tumor recurred locally within 3 weeks and enucleation was performed. Histopathologic examination of the globe confirmed the diagnosis and did not reveal infiltration of the limbus and conjunctiva. No signs of local recurrence or metastatic disease have been observed 18 months following enucleation. To the authors' knowledge this is the first case of primary corneal hemangiosarcoma described in the feline species.     

A retrospective study of 30 cases of frozen lamellar corneal graft in dogs and cats

Frozen lamellar corneal grafts and nictitating membrane flaps were used in 18 dogs and 12 cats to repair deep corneal defects. In all dogs either melting corneal ulcers or descemetoceles were present. In the 12 cats, nine had either a melting corneal ulcer or descemetocele, two animals had acute bullous keratopathy, and one cat had corneal sequestrum. Initial vascularization with gradual clearing of the graft occurred during the first 45 days postoperatively. At 60 days postoperatively, all eyes were visual. Frequent postoperative complications included: focal dehiscence of the wound ( n  = 9); melting of part of the graft ( n  = 7); and pigmentation of the graft ( n  = 4). The frozen lamellar corneal graft was a very safe technique, and restored the tectonic and the optical function of the cornea. It provided the best results in corneas with nonperforating corneal defects. This technique provides poorer results when the cornea was perforated prior to surgery or during the surgical procedure.