What is the third eyelid?
Unlike humans, most animals have a third eyelid (monkeys, snakes and most fish do not). The third eyelid or nictitating membrane is a structure located at the level of the internal angle of the eye which, It includes a T-shaped cartilage and a lacrimal gland, also called accessory or nictitating lacrimal gland. This gland is normally found at the base of the cartilage and can not be seen. The third eyelid serves to protect the eye and distribute the tears on its surface. The accessory lacrimal gland contributes significantly to the total production of tears.
What is prolapse of the accessory lacrimal gland?
Once dislocated, the gland is exposed to air, dust and infectious agents. It will then become irritated and will ignite. It is then that it appears as a red mass at the level of the inner corner of the eye, resembling a cherry (in English this anomaly is taken again under the name of 'cherry eye', 'cherry' meaning cherry And 'eye' eye). Usually, a flow of tears is observed because they can not reach the site of natural elimination (the tear duct). The inflamed conjunctiva will produce mucus which can develop a yellow-green appearance in case of infection. The prolapse of the gland can occur at the level of a single eye or both eyes at the same time.
What is the cause of prolapse of the nictitating gland?
The nictitating gland is normally well buried, behind the orbital arch (bone) under the eye. It happens that the gland turns around, for reasons not yet well understood. It is believed that the change in position of the gland, prolapse, is due to excessive laxity or relative weakness of the tissues surrounding the globe, which is often the case in dogs with drooping eyelids.
The swelling of the tissues observed is the consequence of prolonged exposure.
Is my pet predisposed to prolapse of the lacrimal gland?
It is usually the young dogs that are affected (less than two years). Prolapse is more frequent in American cockerels, beagles, English bulldogs, lhassa apsos, Pekinese and shar-pei. That said, it is found in any other race. There is no effect of sex, which means that the males are as much affected as the females. In predisposed animals, prolapse is most commonly seen in both eyes, although it may take days, weeks or months before the second gland is also luxurious.
In the cat, this anomaly is rather rare but can reach individuals of any age. However, the Burmese and the short-haired Europeans had a higher incidence.
What are the treatments ?
The best treatments for the prolapse of the lacrimal gland are surgical. They involve replacing the gland in its normal position under general anesthesia and anchoring it, suturing it to the deep tissues in the orbit. Several techniques exist. The one that will be used to treat your pet will be chosen according to age, breed and conformation but also according to the personal preference of the surgeon.
A few years ago, the treatment of choice was to remove the gland, which was very easy and quick to do and therefore quite economical. Since then, it has been proven that this gland is responsible for the production of one third of the tears. Thus the withdrawal of the gland predisposes to the development of lacrymal insufficiency, of dry eye (see the information sheet on the dry eye). Once lacrimal function is compromised by excision of this gland, the only treatment is to apply artificial tears as often as possible, daily and for the life of the affected animal; Or to carry out a transposition of the parotidien canal (see the information sheet on this subject).
THE WITHDRAWAL OF THE GLAND IS THEREFORE MAJORLY DISCONTINUED.
Anti-inflammatory local treatment (eye drops or ointment) is not an alternative to surgery, even if it is prescribed before the operation to reduce swelling due to inflammation, facilitates the repositioning of the gland And decreases the risk of prolapse recurrence. It is sometimes possible to manipulate the gland of a waking animal and to replace its gland without surgery, but in the majority of these cases the gland will re-luxuriate again in a shorter or shorter time.
What care will I have to bring to my pet after surgery?
Your pet can usually go home on the day of surgery and should behave normally the next day. However, it is not abnormal that the eye is swollen or red, but this is lessened in the days following the operation.
In some cases, the eye may remain pink and mucous discharge may be present until the sutures are completely resorbed. In most cases, an antibiotic ointment (to be used for one to two weeks) and anti-inflammatory tablets will be prescribed. Some animals must wear a collar for a few days to prevent them from scratching their eye (s) (eye) is not normal that your pet pinches the eyelids or that the eye is painful, remains red or develops a yellow-green flow . If this is the case, you should contact your veterinarian as soon as possible.
What complications can prolapse of the lacrimal gland result?
Once 'luxated', the gland becomes inflamed and becomes irritated, which is a source of discomfort for the patient. Your dog may then try to rub his eye. Unfortunately, if this is the case, it can lead to complications such as corneal ulcers or lesions of the gland or eyelids.
When no surgery is performed and the gland remains exposed for a long time, it will fibrosate (scar tissue formation), atrophy (become smaller) and lose its ability to produce tears with the same consequences as when shrinking Of the gland. Thus untreated nictitating gland prolapses also cause lachrymal defects or dry eye (see the information sheet on this subject). This is why the success of the surgery is more important when this is done very soon after the dislocation of the gland is observed.
What are the possible complications after surgery?
If the surgery is performed in a short time, the gland should return to normal function quickly. As with any surgery, complications can occur; In this case, the gland may re-proliferate, infection of the site develops, suture problems or a cyst forming. In the case of recurrence (when the gland is again 'dislocated'), surgery can be repeated. These recurrences are more frequent in certain breeds such as mastiffs or bulldogs or when surgery has already been carried out with the patient being referred to the specialist. The 'landfill' technique has a success rate of 90% when performed by an experienced surgeon, using the appropriate suture and accurately positioning its stitches.
