The gland should not be removed as keratoconjunctivitis sicca may occur after resection in predisposed breeds.Īdenocarcinoma, hemangioma, hemangiosarcoma and lymphoma as well as squamous cell carcinoma are common neoplasia of the third eyelid. The author's preference is a modification of the pocket technique described by Morgan et al. Several techniques for surgical reposition have been described. A laxity of the connective tissue combined with a lymphoid hyperplasia has been claimed to be the cause of the prolapse. Protrusion or prolapse of the nictitans gland ('cherry eye') occurs most commonly in certain dog breeds (brachycephalics as well as giant breeds) and occasionally in cats. The author's preferred suture material is vicryl® 6-0. Suturing with the knots placed on the anterior surface avoids frictional irritation of the cornea. The author prefers to combine the resection with a small conjunctival 'pocket' as used for the gland reposition (see below) to prevent a prolapse of the nictitans gland postoperatively. Surgical correction involves resection of the scrolled part of the cartilage from the bulbar aspect of the nictitans. It occurs mostly in dolichocephalic large dog breeds like the Great Dane, Saint Bernard, Newfoundland or Doberman and may be hereditary. This will evert the free margin of the nictitans. Scrolling of the third eyelid is a uni-or bilateral condition caused by an abnormal curvature of the vertical portion of the T-shaped cartilage. Granulomas may occur in cats after claw injuries. The lymphocytic plasmacytic infiltration (pannus) of Shepherds will affect most obviously the leading edge of the nictitans. Most conjunctival disorders will involve the nictitans as well. Restoration of a smooth free margin is mandatory.

Small flaps of the free margin can be removed. Careful appositional suturing as soon as possible after the traumatic event may prevent deformation and shortening of the nictitans. Injuries to the third eyelid may cause conjunctival flaps and involve the free margin. Read the German translation: Probleme Des 3.

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