Eyelid mass removal

Third eyelids are most often removed due to tumor involvement (usually SCC). See youtube video. Block the auricopalpebral nerve and supraorbital nerve. Apply topical proparicane or lidocaine. Use mosquito hemostats to lift the third eyelid up and extend it laterally. Inject local anesthesia in the dorsal and ventral margins of the base of the third eyelid. Once the block is in place, you can easily manipulate the third eyelid. You need to remove as much of the third eyelid as possible. Place two curved forceps across the dorsal and ventral margins, beyond the T shaped cartilage. Cut along the forceps with Mayo scissors. Leave the forceps in place for 1-3 minutes to provide hemostasis. Allow the surgery site to heal by second intention. NSAID administration is needed for 3-5 days and a topical antibiotic can be placed in the eye twice daily for 5 days.

As a side note, the presence or absence of third eyelids should be noted as part of prepurchase examinations.

Upper or lower lid masses (generally SCC) may be removed using H plasty. It is important to maintain or recreate the eyelid margin. This surgery pulls up skin from lower on the face to create the margin. Really cool and works in all species.

Equine periocular sarcoids are generally not removable (removing them would leave a huge gap and cause exposure keratitis). We treat these with imiquimod (safe near the eye), cisplatin beads and/or other chemotherapeutic injections. Combination therapy can be useful.

Resources

D Brooks, Removal of the third eyelid. 2005 Clinicians Brief

B Welker et al. Excision of Neoplasms of the Bovine Lower Eyelid by H-Blepharoplasty. Veterinary Surgery, 20, 2, 133-139, 1991