Lump on inner corner of eyelid?

[DavidDane]

Hey guys,

Rocket has had this lump on the inner corner of his eyelid for the past week. That is at least when I first noticed it. Has anyone seen this before? Could it be that he scratched it? Could it be a sty? Blocked tear duct?

The vet who trimmed his teeth couldn't really get a good look at the time, but he gave me an opthalmic ointment with neomycin, polymyxin, and bacitracin zinc in it that I've been applying twice a day. It seemed to be slowly getting better, I think, but today I can't really tell. I would really appreciate any suggestions.

Thanks!

David

[Diggie's Friend]

It definitely looks irritated; this likely from him rubbing or scratching at it.

There are few things it might be that result in an enlargement at the inside corner of the eyelid, including a scratch, a foreign object, a clogged tear duct and most rarely a growth.

Not sure, but this may be an enlarged irritated tear duct; as to the cause if it were, I can't say.

I hope one or more of the regular rehabbers here will chime in on what they think this looks like to them.

[SamtheSquirrel2018]

Hey guys,

Rocket has had this lump on the inner corner of his eyelid for the past week. That is at least when I first noticed it. Has anyone seen this before? Could it be that he scratched it? Could it be a sty? Blocked tear duct?

The vet who trimmed his teeth couldn't really get a good look at the time, but he gave me an opthalmic ointment with neomycin, polymyxin, and bacitracin zinc in it that I've been applying twice a day. It seemed to be slowly getting better, I think, but today I can't really tell. I would really appreciate any suggestions.

There are other possibilities and DF listed a few!

Thanks!

David

Hi David:
This appears to me to be what is called Canaliculitis.

Tears flow over the eye from the tear gland and then pass into two tiny passages called the Lacrimal Canals that have openings in the sides of the upper and lower eyelids toward the tip of the nose. These two canals join at the Lacrimal sac which is connected to the Nasolacrimal Duct which drains tears into the nose. Each of the Lacrimal Canals have a tiny opening in the rim of the eyelid called the Punctum.

The "bump" on Rocket's upper lid is in the same region along the rim of the eyelid where the punctum (the tiny opening) of the upper Lacrimal canal would be. This strongly suggests to me that Rocket has an inflammation and quite possibly an infection involving the upper Lacrimal Canal. An infection in this region can involve just the skin, called a cellulitis and it can also form what is essentially an abscess (a pus pocket). When that occurs, it is not unusual to see pus draining from the punctum. I don't see that in your photos but you may have noticed pus. Another relatively common cause for this rather uncommon condition of a Canaliculitis is a blockage within the Lacrimal Canal. This usually requires surgery to remove the concretions or whatever is causing the obstruction.

Ideally, it would be advantageous for Rocket to be evaluated by a Veterinary Ophthalmologist (an animal eye specialist) ASAP! I realize this is far easier for me to say than for you to make happen! Do you have any systemic antibiotics available, such as Amoxicillin plus Clavulanate or others? This may help but if there is a physical blockage in the canal, it is unlikely that antibiotics (either the topical antibiotics or systemic antibiotics) will be curative as the concretion or whatever is causing the blockage will need to be surgically removed. Using the topical antibiotics you have along with a systemic antibiotic may be another treatment option that you and your Vet may consider. Also, your Vet may know of a Veterinary Ophthalmologist that would be willing to see Rocket!

I'm sorry about Rocket's eye condition and I wish the Little Guy a speedy and uneventful recovery!

Regards,
SamtheSquirrel

[SamtheSquirrel2018]

I just saw where my last intended comment was inadvertently deleted by me from my post when I was fumbling around on my keyboard! I wanted to also point out that there are other possibilities for this condition and DF has mentioned some of these!
Regards,
StS

[DavidDane]

Hi David:
This appears to me to be what is called Canaliculitis.

Tears flow over the eye from the tear gland and then pass into two tiny passages called the Lacrimal Canals that have openings in the sides of the upper and lower eyelids toward the tip of the nose. These two canals join at the Lacrimal sac which is connected to the Nasolacrimal Duct which drains tears into the nose. Each of the Lacrimal Canals have a tiny opening in the rim of the eyelid called the Punctum.

The "bump" on Rocket's upper lid is in the same region along the rim of the eyelid where the punctum (the tiny opening) of the upper Lacrimal canal would be. This strongly suggests to me that Rocket has an inflammation and quite possibly an infection involving the upper Lacrimal Canal. An infection in this region can involve just the skin, called a cellulitis and it can also form what is essentially an abscess (a pus pocket). When that occurs, it is not unusual to see pus draining from the punctum. I don't see that in your photos but you may have noticed pus. Another relatively common cause for this rather uncommon condition of a Canaliculitis is a blockage within the Lacrimal Canal. This usually requires surgery to remove the concretions or whatever is causing the obstruction.

Ideally, it would be advantageous for Rocket to be evaluated by a Veterinary Ophthalmologist (an animal eye specialist) ASAP! I realize this is far easier for me to say than for you to make happen! Do you have any systemic antibiotics available, such as Amoxicillin plus Clavulanate or others? This may help but if there is a physical blockage in the canal, it is unlikely that antibiotics (either the topical antibiotics or systemic antibiotics) will be curative as the concretion or whatever is causing the blockage will need to be surgically removed. Using the topical antibiotics you have along with a systemic antibiotic may be another treatment option that you and your Vet may consider. Also, your Vet may know of a Veterinary Ophthalmologist that would be willing to see Rocket!

I'm sorry about Rocket's eye condition and I wish the Little Guy a speedy and uneventful recovery!

Regards,
SamtheSquirrel

Hey Guys,

Thanks for the replies! I will try to get him an appointment, though we have a long weekend and I'm not sure what to do until Tuesday. Does Dr. Emerson in Florida treat eyes? I have amoxicillin but only 500mg for humans. Other than that I have this Neomycin opthalmic ointment that I'm not sure is helping or not, I have animax/Dermalone ointment that I'm not sure is safe to use in the eye, and I have a supply of SMZ-TMP antibiotics that have been in the fridge for about 5 or 6 months. Should I start him on those until I can get in to see the vet?

[DavidDane]

Actually the bottle of SMZ-TMP I have in the fridge is about 10 or 11 months old. Any ideas on the shelf life of that antibiotic, if it would be safe and/or effective?

[SamtheSquirrel2018]

Hey Guys,
Thanks for the replies! I will try to get him an appointment, though we have a long weekend and I'm not sure what to do until Tuesday. Does Dr. Emerson in Florida treat eyes? I have amoxicillin but only 500mg for humans. Other than that I have this Neomycin opthalmic ointment that I'm not sure is helping or not, I have animax/Dermalone ointment that I'm not sure is safe to use in the eye, and I have a supply of SMZ-TMP antibiotics that have been in the fridge for about 5 or 6 months. Should I start him on those until I can get in to see the vet?

Hi David:
Please do NOT use Animax in the eyes. This is medication is NOT made for use around or in the eye and is most likely very unsafe if used for eye conditions! Dr. E is not a Veterinary Ophthalmologist but i'm sure she does treat certain eye disorders. Again, I am not absolutely certain that this is a Canaliculitis although it appears to me to be that. IF this is a Canaliculitis AND IF it is caused by a blockage in the associated Lacrimal Canal, a very specialized surgery is required. An eye specialist is usually required for this.

Actually the bottle of SMZ-TMP I have in the fridge is about 10 or 11 months old. Any ideas on the shelf life of that antibiotic, if it would be safe and/or effective?

Can you post photos of the bottle of SMZ-TMP that you have. Some antibiotic suspensions are prepared by the pharmacist (or other) by mixing a powdered form of the antibiotic with water. This preparation usually has a specified and/or limited time for it to be used after which it should be disposed.

The SMZ-TMP suspensions with which I have familiarity are a bit different and prepared as a suspension (and will need to be shaken immediately before use) by the manufacturer and are designed to be kept at room temperature between 20-25 Degrees C (that is 68 to 77 degrees F). This suspension, assuming it is cared for as the manufacturer recommends, is considered "good" until the expiration date on the bottle. Please post photos of this before you consider using it. Thanks,
Regards,
SamtheSquirrel

[Diggie's Friend]

Oh yah; Dr E. is a is very knowledgeable in treating various ill health conditions common to various species of squirrels.

[DavidDane]

Hi David:
Please do NOT use Animax in the eyes. This is medication is NOT made for use around or in the eye and is most likely very unsafe if used for eye conditions! Dr. E is not a Veterinary Ophthalmologist but i'm sure she does treat certain eye disorders. Again, I am not absolutely certain that this is a Canaliculitis although it appears to me to be that. IF this is a Canaliculitis AND IF it is caused by a blockage in the associated Lacrimal Canal, a very specialized surgery is required. An eye specialist is usually required for this.



Can you post photos of the bottle of SMZ-TMP that you have. Some antibiotic suspensions are prepared by the pharmacist (or other) by mixing a powdered form of the antibiotic with water. This preparation usually has a specified and/or limited time for it to be used after which it should be disposed.

The SMZ-TMP suspensions with which I have familiarity are a bit different and prepared as a suspension (and will need to be shaken immediately before use) by the manufacturer and are designed to be kept at room temperature between 20-25 Degrees C (that is 68 to 77 degrees F). This suspension, assuming it is cared for as the manufacturer recommends, is considered "good" until the expiration date on the bottle. Please post photos of this before you consider using it. Thanks,
Regards,
SamtheSquirrel

Hey Sam!

The bottle says it's liquid suspension and it's a chalky pink color. It doesn't have an exp date because it was given by my local vet and just has the prescription info. I started him on it anyway a day ago. Here are some pictures I just took this morning. Let me know what you guys think

[DavidDane]

This is from tonight. The top is looking like the bottom now instead of just being a small lump. I emailed Dr. Emerson last week but haven't heard back from her yet. He's showing signs of a skin infection I treated him for last year multiple times. I never found out what it was but the antibiotics got rid of it each time. I wonder if this could be related? I did start him on the SMZ-TMP because of that, but it takes a few days to start working from my experience, and I'm not sure if it's still effective after 10 months? Is there another opthalmic ointment I should ask my local vet to prescribe?

Just an fyi... I never really found out what caused his skin injection, but it would return every few months and I'd have to do another round of SMZ-TMP. This last time he's gone almost a year without anything popping up. Could a staph infection or bacterial infection cause this in the eye?

[SamtheSquirrel2018]

This is from tonight. The top is looking like the bottom now instead of just being a small lump. I emailed Dr. Emerson last week but haven't heard back from her yet. He's showing signs of a skin infection I treated him for last year multiple times. I never found out what it was but the antibiotics got rid of it each time. I wonder if this could be related? I did start him on the SMZ-TMP because of that, but it takes a few days to start working from my experience, and I'm not sure if it's still effective after 10 months? Is there another opthalmic ointment I should ask my local vet to prescribe?

Just an fyi... I never really found out what caused his skin injection, but it would return every few months and I'd have to do another round of SMZ-TMP. This last time he's gone almost a year without anything popping up. Could a staph infection or bacterial infection cause this in the eye?

Hi David:
It may be a good strategy to call Dr. E's office tomorrow morning and let them know that you sent an email (hopefully with the photos!) to Dr. E and you would like to know if she has been able to review this yet and if not, can they give you an idea as to when!

The "bump" does not seem so prominent in these later photos!

Just for a contingency, do you have any other ophthalmic antibiotic drops or ointments available other than the ointment your are currently using?

My concern with the "old" SMZ-TMP is that if this was given to you by your Vet and mixed/diluted for Rocket to take 11 months ago, it may now be contaminated and spoiled! IF this is a bottle of SMZ-TMP suspension that came directly from the manufacturer and has not been mixed with anything or in contact with something not sterile AND you have kept it sealed, it may still be "good" after 11 months. Do you have any photos of the SMZ-TMP bottle?

Regards,
SamtheSquirrel

[DavidDane]

Hi David:
It may be a good strategy to call Dr. E's office tomorrow morning and let them know that you sent an email (hopefully with the photos!) to Dr. E and you would like to know if she has been able to review this yet and if not, can they give you an idea as to when!

The "bump" does not seem so prominent in these later photos!

Just for a contingency, do you have any other ophthalmic antibiotic drops or ointments available other than the ointment your are currently using?

My concern with the "old" SMZ-TMP is that if this was given to you by your Vet and mixed/diluted for Rocket to take 11 months ago, it may now be contaminated and spoiled! IF this is a bottle of SMZ-TMP suspension that came directly from the manufacturer and has not been mixed with anything or in contact with something not sterile AND you have kept it sealed, it may still be "good" after 11 months. Do you have any photos of the SMZ-TMP bottle?

Regards,
SamtheSquirrel

Yeah I completely understand. Sure here is a picture of the bottle and the Rx. This larger bottle has been untouched because I pour it into another one that I use for the syringe

[DavidDane]

I took these pictures this morning. It has grown larger than just the lump it started out as. I've noticed he also has another lump or two starting further down the upper eyelid. The other stange thing is that he's also getting a few lumps or lesions on other parts of his face and body that are similar I think to the skin infection he had last year. I don't know if it's coincidence or if they are related? I called Dr Emerson's office but they said she won't even be back until Friday. I'm not sure what to do. Is there another eye ointment I should try to have my local vet try?

[Diggie's Friend]

A close up taken of the normal eye for comparison may be helpful.

[SamtheSquirrel2018]

Yeah I completely understand. Sure here is a picture of the bottle and the Rx. This larger bottle has been untouched because I pour it into another one that I use for the syringe

I can't tell from looking at the bottle and portion of the label you photographed as to whether or not this was diluted but I suspect so. SMZ-TMP suspension is provided by the manufacturer in 16 oz for both Veterinary and Human use. The small squirt bottle is obviously not original. I'm a litle concerned about using it but this is obviously your call!

In regard to the photos, it appears to me that Rocket now has developed some tiny vesicles (blisters) in the corner of his eye. It may be the photo but that is how it appears to me. If that is the case, does the seem to be any white material within the blisters. It does not appear so to my sub-par eyes but please verify and maybe even post a closer close-up. Also, it would be nice and DF has suggested, to have comparison photos of the other eye. IF there are blisters and there is no white material (if there is white material within, this would most likely be pus and indicate an infection). One of my concerns is that the eye antibiotic ointment that is being given to Rocket contain three different antibiotics including neomycin. The more antibiotics that Rocket is exposed to, the more chance there is that he will have an allergic or hypersensitivity reaction to at least one of these. Also, as I have mention in some of your other threads and elsewhere, I am not a fan of topical use of neomycin as of all of the topical antibiotics, it is one of the most likely to cause a hypersensitivity reaction (allergic reaction). What may be going on is that the original "bump" has resolved by itself for whatever reason and now the blisters (if that is what I am actually seeing) and what appears to be swollen skin in the corner of Rockets eye has developed an allergic reaction from exposure to one of the antibiotics contained in the ointment and if so, the most likely culprit would be the neomycin. As you know, DD; I am not a Vet and I certainly don't want to appear to be questioning your Vet or in any way come between you and your Vet! I would suggest discussing what is currently going on and all your concerns with your Vet. Also, if your Vet felt that systemic antibiotics were a good option, maybe he would prescribe what you will know to be a fresh supply!
Regards,
SamtheSquirrel

[DavidDane]

Hey!

Thanks for the replies! I have been treating him with the SMZ-TMP since last Saturday. I was able to get a new refill of it on Tuesday. A vet opthalmologist replied to my email and said she couldn't diagnose him by the pictures but it was very possible it could be related to what he had before with the skin infection. The other bumps on his skin I was seeing are starting to stop being red. His eye doesn't really seem to be getting worse, but I'm not seeing it get better yet. It doesn't look red or irritated. Here is a recent picture I just took this evening

[SamtheSquirrel2018]

Hey!

Thanks for the replies! I have been treating him with the SMZ-TMP since last Saturday. I was able to get a new refill of it on Tuesday. A vet opthalmologist replied to my email and said she couldn't diagnose him by the pictures but it was very possible it could be related to what he had before with the skin infection. The other bumps on his skin I was seeing are starting to stop being red. His eye doesn't really seem to be getting worse, but I'm not seeing it get better yet. It doesn't look red or irritated. Here is a recent picture I just took this evening

I'm glad that you have obtained some fresh SMZ-TMP and that you were able to get the opinion of a Veterinary Ophthalmologist! Is Rocket still getting the original eye antibiotic oitment or is this discontinued?
Regards,
SamtheSquirrel

[DavidDane]

Hey Sam!

I actually haven't been giving that to him for 3 or 4 days now. It didn't seem to irritate him when I was giving it, but it didn't really seem like it was helping much either. Here's another picture from tonight. I think I'm starting to see an improvement now in the size and look compared to the previous photo.

[SamtheSquirrel2018]

Hey Sam!

I actually haven't been giving that to him for 3 or 4 days now. It didn't seem to irritate him when I was giving it, but it didn't really seem like it was helping much either. Here's another picture from tonight. I think I'm starting to see an improvement now in the size and look compared to the previous photo.

Hi David. Thank you for your encouraging update! I apologize for missing this most recent post! How is Rocket doing today?
Regards,
SamtheSquirrel

[DavidDane]

Hi David. Thank you for your encouraging update! I apologize for missing this most recent post! How is Rocket doing today?
Regards,
SamtheSquirrel

Hey Sam!

Thanks for the reply. He is doing even better today. The lumps seem to be getting better and smaller Here's a photo from this evening.