Image Quiz: Ophthalmology-Chronic tears in a springer spaniel

This 3-year-old male springer spaniel has a chronic history of facial tear staining and ocular discharge that is often purulent. The condition has been treated with topical and systemic antibiotics, topical and systemic antioxidants, as well as oral homeopathy, and it sometimes gets better but always relapses.

Given the history described, the fact that the ocular surface is normal, the presence of blood on the upper eyelid, and the structure present at that location, what procedure was just performed?

a) Implantation of a subpalpebral lavage system

b) Placement of a nasolacrimal catheter

c) Eyelid biopsy

d) Placement of a third eyelid flap