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Meibomian Eyelid Tumours

Advice for this condition in Dogs - Lucy's Story

“Lucy” was a beautiful, friendly, nine-year-old Springer Spaniel. She was brought into the surgery as her owners were concerned about a large, mass lesion that had been slowly growing on her lower eyelid of her Left eye, and this seemed to be troubling her recently. Lucy had been constantly rubbing at this eye and it was now weeping a lot. 

On her examination it was noted that Lucy had a large eyelid mass lesion. This was rubbing on her eye and was causing her some discomfort, and it was advised that this lesion be removed surgically.

The eyelids of dogs contain Meibomian glands. These tiny oil glands are a type of sebaceous glands that produce an oily secretion that assists in forming a tear film that helps keep the eyes moist and comfortable by lubricating them. There are dozens of these tiny glands located in each eyelid with this function.  

Sometimes these Meibomian glands can become blocked, or they can form tumours. Meibomian gland eyelid tumours are tiny, slow-growing tumours that form in the meibomian glands of the eyelids. These gland tumours are usually benign, are common, and are more often seen in older dogs over eight-years-old. Meibomian Gland Adenomas are benign age-related eyelid tumours which can result from the accumulation of glandular material. They start as small, raised “bumps” at the margin of the upper and lower eyelids. Many of these can stay small, 2 - 3mm. However, if they become large enough, they can cause a local irritation to the eye cornea and conjunctivae. A very small percentage of them can be cancerous carcinomas that can metastasize into local lymph nodes 

Some very small, blocked glands will resolve on their own. Small meibomian gland tumours should be monitored closely, to see if they grow, and to ensure that they are not causing any issues. Larger Meibomian gland tumours can be a problem to the adjacent eye structures, and they do need removed if they protrude and extend into the eyelid and eye structures. These eyelid tumours can be inside or outside the eyelid. Benign tumours do not spread, but they can become inflamed, irritated, and painful. Some of these tumours will become ulcerated and can cause a secondary keratoconjunctivitis, an inflammation of the cornea and conjunctiva. If the tumour becomes large enough, it can cause problems during blinking, resulting in excess eye discharge, tearing and tear staining and if they become large the affected eye may be unable to shut correctly. Most benign tumours grow slowly, however, they can become troublesome and uncomfortable if they grow to be large enough to scratch the adjacent eyeball, the eye cornea, causing irritation and discomfort and corneal ulceration. 

Usually, these eyelid tumours are benign, however, sometimes the masses starting from these same eyelid glands are sebaceous adenocarcinomas, a type of cancer which can spread into the adjacent lymph nodes. Other malignant eyelid tumours can come from other eyelid structures too. Cancerous masses are less common in dogs than the benign lesions, but it is not always possible to tell them apart just by looking at them. Sebaceous adenocarcinomas are rare, these tumours are generally large and rapidly growing and can also rupture into the surrounding tissues causing an inflammatory response, ulceration, pain, and damage to the adjacent eye structures.  

Lubricating eyedrops can be given to make the eyelid slide over the mass and cornea more easily and antibiotic eye drops can be given if there is any secondary infection. The eye won't be as comfortable as after a mass is removed, but these treatments can help the dog be more comfortable. 

Large and concerning eyelid mass lesions are advised to be removed surgically. A referral to a Veterinary Ophthalmologist for surgery may be advised and required for some intricate or multiple lesion surgeries. The surgical approach depends on the size and location of the mass. Generally, they are removed using a “V” wedge excision of the affected eyelid. If the tumour isn’t completely removed, it may continue to grow. In some cases, a sedative and local anaesthesia will be necessary. The larger the lesion, the more likely that general anaesthesia will be required. Laser and Cryosurgery may also be used alongside surgery to completely remove the tumour. A Histopathological evaluation is advised of any large, rapidly growing mass eyelid lesion. 

Only about 10% of the benign eyelid tumours recur after surgery. If they do, you’ll most likely see them return within 6 months, so it is advised to keep the patient’s eyes and eyelids closely monitored.  

Lovely “Lucy” recovered well from her eyelid mass surgery. Also, a Histological report of the mass lesion confirmed, thankfully, that this was indeed a benign Meibomian gland adenoma lesion. Lucy’s owner was given some lubricant drops to apply to the eye to lubricate it after her surgery, and she was soon a much happier dog, and much more comfortable after this mass lesion had been removed. Lucy’s eyes were monitored closely at the surgery thereafter, for any regrowth or other new eyelid mass lesions. 

If you are concerned about any mass lesions in your dog’s eyelids, do have them checked over by your Vet. 

Alison Laurie-Chalmers
Senior Consultant
Crown Vets. 

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