Deep corneal eye ulcer from dry eye
Berry Haven Veterinary Group Medical Case
Tex was presented for examination of a chronic eye problem which had been seen by 2 other vets who had diagnosed conjunctivitis and rolling in of the eyelids (entropian).
On examination, the left eye was very inflamed with a thick mucous discharge. The cornea had a blue colour to it (corneal oedema) and in the centre of the cornea was a deep crater which had nearly perforated the eye.
A tear test, using a special strip of blotting paper, showed she was not making any tears in the eye. Normally, we expect to see a reading of 15mm or more over 60 seconds. We diagnosed a condition called Dry Eye.
If there are no tears in an eye, the central part of the cornea dries out and is attacked by the bacteria that live there normally. Sometimes, these bacteria can be quite nasty and produce chemicals which dissolve the cornea very quickly, making the ulcer very deep and large. Left untreated, the cornea ruptures and the fluid in the eyeball leaks out leading to loss of the eye.
We admitted Tex for emergency surgery. We cleaned up the ulcer with some sterile buds and saline before doing a third eyelid flap where we place the extra eyelid across the eye and stitch it in place for 2-3 weeks. Prior to stitching the third eyelid, we scrapped its inside surface with a scalpel blade to make it bleed as fresh blood contains a chemical which stops the melting process going on in the cornea.
The third eyelid protects the cornea and allows it to heal. We put some very strong antibiotic drops in the eye and started on artificial tears and Optimmune.
At 3 weeks, we removed the third eyelid flap and the cornea had nearly filled in. We are continuing with the artificial tears and Optimmune to keep the eye moist and prevent repeat episodes.