Follicular Hyperplasia diagnoses

[jrpearso]

I've noticed since I got my dog from the humane society that some days his eyes are more red than others, specifically his left eye and almost every morning he has discharge coming from both eyes. I recently took him to the vet for this problem and he was diagnosed with follicular hyperplasia which is apparently where something gets caught under his third eye lid, irritates it and then nodules/small bumps grow underneath causing redness/discharge/discomfort. The vet said that eye drops would provide temporary relief, but only surgery would potentionally cure this problem. I haven't heard of this disorder and would just like another vet's opinion on. I want the best for my dog, but I am in graduate school and if I dont' HAVE to get this surgery for my dog and save the estimated $180 then I will. Thank you for any advice/guidance!!

[Aleda M Cheng, D.V.M., C.V.A]

Follicular conjunctivitis or follicular hyperplasia is a disease of the lymphoid follicles that are present on the conjunctiva of the eye.  It represents an exaggerated reaction by these follicles to environmental allergens.  The greatest number of the follicles are beneath the surface of the nictitans membrane (third eyelid), and that is where the problem is most apparent.  The conjunctiva of the eye becomes bloodshot, and there is increased discharge surrounding the fluid filled lymphoid follicles.  The swollen, fluid filled follicles cause increased friction beneath the eyelid.  Increased friction causes the eye to become even more inflamed, irritated, swollen and uncomfortable.  

The condition is commonly found in younger dogs, and can sometimes be self limiting (can resolve spontaneously).  For diagnosis, a cytological exam of the discharge of the eye shows increased lymphocytes and plasma-cells, which are cells associated with allergy.

Eye drops containing dexamethasone, or other anti-inflammatories may help temporarily.  A NON-SURGICAL procedure can be performed to reduce the friction of the engorged follicles thus providing relief.  This procedure can be performed using a topical (local anesthetic) ophthalmic anesthesia.  

There is a possibility that the problem may resolve on it's own.  However, if your dog is very painful,  it might be a good idea to consider the procedure.   PLEASE NOTE: the procedure that I have described above is not a surgery.

Ideally, if you had the funds it might be best to get a second opinion by another veterinarian, who can actually examine your dog.

[jrpearso]

Thank you so much for your explanation and recommendations for treatment. My only question now is if the topical ophthalmic anesthesia is the treatment itself or if they use that just to numb the eye while they perform some procedure (my vet described a procedure where they scrap the follicles off the eye itself). Again, I really do appreciate you taking the time to answer my question!