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About six weeks ago my horse developed a runny eye. A couple of days later I noticed a small lump on his head, between his eyes. I left it alone for a week, as I tought that he had maybe banged it on something.

When I realised that there was no improvement I called out the vet who has diagnosed either sinus problems or a blow to the head. He was put on a three week course of bute to try and ease the inflamation. Up to now their has been no improvement and if anything the lump seenms to now be forming a band between the eyes. Other than this there are no other symptoms, and the affected eye is only weeping a little more than normal. Any advice would be much appreciated as this is not something that anybody seems to have seen before (I am on a livery yard with seventy horses). Thank You

This condition is unlikely in fact to be sinus disease at this site but an
X-ray would clarify that. It is likely that this is the condition with the
long name of.. wait for it.... naso-fronto-maxillo-lacrimal suturitis. This is a reactive change that takes place in the joins between the flat bones of the head. The skull is made up of a series of flat bones joined by tiny zig-zag seams. There is a very strong and thick seam in two small arches that join between and just below the eyes. The condition does sometimes follow a blow to the head but more often it just appears one day. You are probably wondering why the eye discharge?

The nasolacrimal duct that carries tears to the nose passes down a bony canal that is made by joining several of these plates of bone around the duct. When this condition affects the nasal and lacrimal bones the duct becomes squashed and often closed completely. This means that the tears simply overflow from the eye. The patency of the eye can be tested by putting a drop of dye into the eye and seeing if it appears at the nose 15 - 30 minutes later.

The pictures show the suture lines and the origin of the
nasolacrimal duct. The red tape is a nerve NOT the nasolacrimal duct.

The condition is not treatable in the sense that the lumps will go away. The best hope is that it will settle with time. Get your vet to X-ray the head perhaps and possibly to check for the nutritional balance between calcium and phosphate which is sometimes blamed for the condition. You have not said how old your horse is because sometimes this condition occurs when the suture lines are finally closing (usually around 5 - 7 years of age). After that stage the condition can occur nonetheless.

Hope this helps

Derek C Knottenbelt BVM&S, DVMS, DipECEIM, MRCVS
Philip Leverhulme Hospital
University of Liverpool

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