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Unilateral choristoma of the nictitating membrane in a horse

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  • 1 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 2 Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
  • | 3 Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

Abstract

Case Description—A 2-year-old Morgan mare was evaluated because of a corneal ulceration.

Clinical Findings—An irregular, deep stromal corneal ulcer in an area of malacia was noted in the left eye. Hypopyon was present in the ventral portion of the anterior chamber with moderate aqueous flare. The nictitating membrane of the left eye had hairs originating from its leading edge that contacted the corneal surface.

Treatment and Outcome—General anesthesia was induced, and a bulbar pedicle conjunctival graft was performed. The conjunctiva at the leading edge of the nictitating membrane, including the aberrant hair follicles, was excised. Microscopically, a nonkeratinized stratified squamous epithelium, sebaceous glands, and hair shafts were present, confirming a choristoma of pilosebaceous origin at the leading edge of the nictitating membrane. Six weeks after surgery, the horse had no signs of discomfort, with no regrowth of the hairs; no loss of vision was evident.

Clinical Relevance—Ocular choristomas develop secondary to defective fetal cellular differentiation and are rarely reported in the equine literature. The choristoma in this horse contained ectopic hair follicles with hair growth as well as sebaceous glands. This finding emphasizes the importance of a thorough adnexal examination in horses with corneal disease.

Abstract

Case Description—A 2-year-old Morgan mare was evaluated because of a corneal ulceration.

Clinical Findings—An irregular, deep stromal corneal ulcer in an area of malacia was noted in the left eye. Hypopyon was present in the ventral portion of the anterior chamber with moderate aqueous flare. The nictitating membrane of the left eye had hairs originating from its leading edge that contacted the corneal surface.

Treatment and Outcome—General anesthesia was induced, and a bulbar pedicle conjunctival graft was performed. The conjunctiva at the leading edge of the nictitating membrane, including the aberrant hair follicles, was excised. Microscopically, a nonkeratinized stratified squamous epithelium, sebaceous glands, and hair shafts were present, confirming a choristoma of pilosebaceous origin at the leading edge of the nictitating membrane. Six weeks after surgery, the horse had no signs of discomfort, with no regrowth of the hairs; no loss of vision was evident.

Clinical Relevance—Ocular choristomas develop secondary to defective fetal cellular differentiation and are rarely reported in the equine literature. The choristoma in this horse contained ectopic hair follicles with hair growth as well as sebaceous glands. This finding emphasizes the importance of a thorough adnexal examination in horses with corneal disease.

Contributor Notes

Address correspondence to Dr. Pirie (chris.pirie@tufts.edu).