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tvpjournal.com | July/August 2015 | TodAy's VeTerinAry PrAcTice obserVATions in oPhThAlmology Peer reviewed 73 BLEPHARITIS: CLINICAL REVIEW OF DISEASES Chalazion Description. A chalazion (Figure 4) is a frm, non- neoplastic, nonpainful swelling of the meibomian gland caused by accumulation of secretions. it results in chronic infammation and a granulomatous reaction. chalazia are commonly seen in older animals and may be associated with meibomian gland adenomas because they usually obstruct the duct, leading to glandular rupture. 4 Diagnosis. diagnosis is based on appearance of a focal, nonpainful swelling, with nodule formation at the level of the meibomian gland through the palpebral conjunctiva. Treatment. Therapy is provided by: 1. Under local anesthesia with light sedation, attaching a chalazion clamp to affected region of the eyelid 2. making an incision through the palpebral conjunctiva across granuloma with curettage 3. Applying a topical antibiotic/steroid ointment after curettage 4. Allowing the incision to heal by second intention 5. Using cryosurgery as adjunctive therapy to reduce the incidence of recurrence. Bacterial Blepharitis (Staphylococcus & Streptococcus Species) Description. bacterial blepharitis (Figure 5) is characterized by: • Pyogranulomas of the lid, which may involve deeper parts of the eyelid and subcutaneous tissues; diffuse lid inflammation; and meibomianitis • With chronic bacterial blepharitis, ulceration of eyelid skin margins, alopecia, and fibrosis • in some cases, abscessation and impaction of the meibomian glands. The condition is commonly bilateral but may have a unilateral presentation. 3 Staphylococcus and Streptococcus species are the isolates most commonly involved in bacterial blepharitis of adult dogs. 3 in puppies, bacterial blepharitis occurs as part of a juvenile pyoderma in which the entire skin of the head may be involved, with multiple abscesses caused by Staphylococcus species. 3,5 The pathogenic mechanism is related to bacterial presence and the immune-mediated reaction induced by their toxins. 3,5,6 There is no defined breed or sex predilection. Diagnosis. diagnosis includes: • biopsy with histopathologic examination to reveal microabscesses and associated cocci 3 • impression smears of skin lesions affecting eyelids, which demonstrate large numbers of cocci with presence of neutrophilic inflammation 3,6 • culture and susceptibility testing of expressed material. Treatment. culture and susceptibility testing reveals directed antimicrobial therapy, and systemic treatment with cephalexin for at least 3 weeks is most common. if infammation and ulceration are FIGURE 5. Two-year-old castrated male mixed breed dog with bacterial blepharitis ( Streptococcus species). Note diffuse ulceration of both eyelids with nodule formation, crusting, and discharge. Cytology and culture of the purulent discharge from one of the meibomian glands yielded Streptococcus species. A combination of oral antimicrobials, a tapering dose of steroids, and topical antibiotics with a steroid preparation was curative. Courtesy Dr. Ellen B. Belknap FIGURE 4. Ten-year-old castrated male mixed breed dog with a chalazion. Note the frm, nonpainful, and nonneoplastic swelling of the meibomian gland and focal blepharitis. Surgical treatment with a chalazion clamp and curettage was curative. A topical antibiotic preparation with a steroid was also administered due to marked infammation after curettage. Courtesy Dr. Ellen B. Belknap