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Eyelid Defects: Trauma, Masses 319

Possible Complications
• Poor apposition of eyelid margin results in
VetBooks.ir entropion or ectropion, or step to eyelid Diseases and Disorders
cicatrix (scar) formation, predisposing to
margin, resulting in corneal irritation and
ulceration.
• Improperly placed sutures at the eyelid
margin can predispose to corneal ulceration.
• Local regrowth of eyelid mass if mass not
completely removed
Recommended Monitoring
Re-evaluate apposition of eyelid margin, and
remove skin sutures 10 days after surgery.
PROGNOSIS & OUTCOME

• Eyelid laceration: prognosis good if apposi-
tion of eyelid margin is achieved.
• Removal of eyelid neoplasm: dogs, prognosis
good, majority are benign; cats, prognosis
EYELID DEFECTS Eyelid mass. (Courtesy Dr. Phillip A. Moore, Auburn University.) guarded, majority are malignant.
• Local recurrence is possible if an eyelid mass
is not completely excised.

PEARLS & CONSIDERATIONS
lid margin; confirmation of the nature of the • If full-thickness laceration, close in two
mass requires cytologic and/or histopatho- layers (conjunctiva/deep stroma, then skin) Comments
logic assessment. starting at eyelid margin with a figure-eight • Eyelid lacerations are treated surgically as an
suture to ensure accurate apposition of eyelid emergency, not as open wounds, to prevent
Differential Diagnosis margin. eyelid scarring, contraction, and distortion
Eyelid swelling: ○ No suture should penetrate the palpebral of the eyelid margin.
• Anaphylaxis conjunctiva and contact the cornea. • Eyelid masses should be removed early to
• Conjunctival/subpalpebral foreign body Eyelid mass (neoplastic): prevent the need for plasty procedures.
• Surgical removal
Initial Database ○ If involves eyelid margin and ≤ ⅓ length of Prevention
Complete ophthalmic examination (p. 1137): eyelid, remove by a full-thickness V-shaped Limit actinic radiation (sunlight) exposure in
• Schirmer tear test or house-shaped excision white cats to decrease the potential for SCC.
• Fluorescein dye application evaluating for ○ Close in two layers (see above).
corneal ulceration secondary to trauma ○ Eyelid margin mass > ⅓ eyelid length Technician Tips
• Intraocular pressures requires a plasty procedure to ensure Dogs that have had eyelid surgery should
• Examination of periocular (e.g., conjunctiva) proper eyelid length (i.e., H-plasty, wear an Elizabethan collar until the sutures
and intraocular structures, especially if semicircular flap, or lip-to-eyelid rotational are removed.
trauma suspected graft). Consider referral to ophthalmolo-
• Examination of eyelid margin for extent of gist or surgeon. Client Education
laceration or extent and point of origin of • Cryosurgery with curettage Recurrence is possible after the removal of any
mass ○ Useful for benign eyelid mass in older eyelid mass.
animals
Advanced or Confirmatory Testing ○ May be performed under sedation SUGGESTED READING
• Fine-needle aspiration and cytologic evalu- ○ Recurrence rate higher with cryotherapy Maggs DJ: Eyelids. In Maggs DL, et al, editors:
ation of eyelid masses than with full-thickness excision Slatter’s Fundamentals of veterinary ophthalmology,
• Histopathologic evaluation of all surgically ○ May also be effective for small SCC in ed 5, St. Louis, 2013, Elsevier, p 110.
removed eyelid masses cats AUTHOR: Phillip A. Moore, DVM, DACVO
Eyelid mass (chalazion): EDITOR: Diane V. H. Hendrix, DVM, DACVO
TREATMENT • Medical therapy with neomycin-polymyxin-
dexamethasone ophthalmic ointment q 8h in
Treatment Overview combination with warm compresses several
Treatment goals are to restore normal eyelid times a day may be attempted initially.
conformation, eliminate ocular irritation, and • Surgical treatment if no response to medical
prevent recurrence of eyelid mass. Treatment therapy
for an eyelid mass should be initiated early ○ Scalpel incision of overlying palpebral
in the course of the disease to ensure normal conjunctiva with curettage; heals by
eyelid conformation. second intention
• Topical antibiotic/corticosteroid (e.g.,
Acute General Treatment neomycin-polymyxin-dexamethasone
Eyelid trauma: suspension or ointment) q 8h for 7 days
• Laceration requires primary/surgical closure after surgery; corticosteroid contraindicated
of wound. if cornea is not intact.

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