Vet Track #4: Ocular Adnexal Procedures: Eyelids, Third Eyelids, and Nasolacrimal Ducts

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* 1. Attendee Information: Please enter your full name on the first line and the email address your registered with on the second line.

First and Last Name

Email Address

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* 2. Based on current thinking, the following patients with entropion should undergo tacking suture placement rather than definitive surgical repair:

A. Puppies < 12 months

B. Puppies < 9 months

C. Dogs > 12 years

D. Puppies < 4 months

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* 3. In surgical planning for removal of an eyelid margin mass, the following are true:

A. The dimensions of the externally visible portion are the most important, as these will dictate how much skin must be removed.

B. The eyelid should always be everted to facilitate evaluation of the subconjunctival component, as this may significantly impact surgical planning.

C. Debulking a mostly exophytic/narrow based meibomian gland mass from the eyelid margin should ideally be followed by cryotherapy or careful cautery to prevent regrowth.

D. A straightforward wedge resection is a good option for removal of a mast cell tumor occupying the lateral 50% of the upper eyelid in a cat.

E. A, B and C are true.

F. B and C are true.

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* 4. With regards to suture placement for the Morgan Pocket Technique of prolapsed third eyelid gland repair:

A. The larger the suture the better, as these glands can easily prolapse again if the suture breaks down too quickly.

B. It is important to ensure apposition of conjunctival epithelium to conjunctival epithelium to achieve a good result.

C. Placing a single horizontal mattress suture to bring together the subconjunctival tissues (Tenon's fascia) on each side of the incision over the gland can be a useful first step that greatly facilitates the remainder of the closure.

D. Knot placement should always be on the bulbar surface of the third eyelid to prevent the patient from rubbing out the sutures.

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* 5. In assessing nasolacrimal disease in dogs and cats:

A. The Jones test is accurate in all dogs but not cats.

B. The Jones test is accurate in all cats but not dogs.

C. The Jones test can be helpful but should not be used for definitive diagnosis of nasolacrimal obstruction.

D. Brachycephalic dogs and cats typically have shorter nasolacrimal ducts, making the Jones test faster and more reliable in these patients.

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* 6. With regard to eyelid laceration repair:

A. Aligning the eyelid margin is not as important as the base of the wound, as the base of the wound affects eyelid movement.

B. Aligning the eyelid margin is the most important step, as proper alignment facilitates appropriate spread of the tear film and prevents trichiasis and contact of sutures with the cornea postoperatively.

C. Antibiotic therapy never necessary, as the eyelid margins are well vascularized.

D. Eyelid lacerations should always be given 48 hours to heal on their own before attempting closure.