Third eyelid scrolling and surgical treatment - a case report

Abstract

This report describes the clinical presentation, treatment, and outcome of a dog with third eyelid scrolling associated with prolapse of the gland of the third eyelid, which was treated with a modified surgical technique, and determines whether this procedure preserves the functions of the third eyelid, reduces cartilage shortening, eliminates the recurrence and finally improves the vision. An 8-month-old male German shepherd dog was presented with ocular irritation and epiphora. Ophthalmic examination revealed an everted third eyelid associated with a prolapsed nictitans gland. We performed the Morgan pocket technique to reposition the prolapsed gland in the current case, and the incision of deformed cartilage was done simultaneously. The surgical outcome was excellent with no recurrence or other complications. The Morgan pocket technique is a suitable surgical technique, however we corrected eversion of third eyelid by cutting the central portion of the deformed cartilage rather than removing the whole or part of it. This work may provide an alternative surgical treatment of third eyelid scrolling in dog.

Rare Unilateral Nictitating Membrane and T Shape Cartilage Prolapse in Two-Years-Old Mix-Breed Cat

“…In another survey by Rezaei et. Al., the Morgan pocket technique in German Shepherd performed and the outcome was excellent and no recurrence and complication described [1]. In many papers, the age of affecting patients demonstrate the age less than one year but there is a report about everted third eyelid cartilage in 8 years old British Blue cat that introduces the independent age relationship between the affecting nictitans eversion and new susceptible breed [15].…”

“…This gland secretes about 30 -50% of tear production, exclusively [1,2]. Third eyelid prolapse is rare in cats than dogs and is not common merely, so often T shape cartilage protrudes with the third eyelid.…”

Surgical Treatment of Nictitans Membrane Eversion in Dogs

“…The third eyelid scrolling is the rolling out or eversion of the nictitating membrane (Rezaei et al, 2019;Williams and Miller, 2006). The deformity that developed due to the rotation or folding of the Tshaped cartilage of the third eyelid (eversion) toward the lower eyelid clinically manifests itself as the nictitating membrane's partial visibility from outside on the bulbar surface (Çakmakçi, 2019;Rezaei et al, 2019;Williams and Miller, 2006). The condition is a rare ophthalmological disorder in companion animals, more common in dogs than cats (Williams et al, 2012).…”

“…All canine breeds may be affected; nevertheless, some breeds revealed a higher prevalence rate (Çakmakçi, 2019;Ramani et al, 2010). The etiology of the lesion, which has both unilateral and bilateral involvement in dogs, is still unclear, yet genetic predisposition and some environmental factors such as trauma have been suggested as the underlying cause (Çakmakçi, 2019;Rezaei et al, 2019). Clinical signs include epiphora, blepharospasm with relatively mild severity, sudden onset of a pinkish mass or swelling in the medial canthus (Williams et al, 2012), and even a simultaneously occurring nictitans gland prolapse (Hendrex, 2007;Williams et al, 2012).…”

“…Several surgical procedures such as application of a temporary third eyelid flap, resection of the eyelid, resection of the eyelid margin and cartilage, removal of the deformed or bent portion of cartilage, total cartilage resection, and cartilage homograft application, thermal cautery of the nictitating membrane (Allbaugh and Stuhr, 2013;Crispin, 1986;Rezaei et al, 2019), and resection of the gland and cartilage in cases with a concurrent prolapsed gland (Allbaugh and Stuhr, 2013;Michel et al, 2020) are proposed for the surgical correction of outwardly rotated/everted nictitating membrane.…”