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Corneal Ulcer, keratitis

A corneal ulcer is an abrasion or defect in the clear surface tissue of the eye. Ulcers may be shallow or deep. This is a painful condition, the signs that are usually seen are squinting and tearing. Many ulcers are caused by trauma -- possibly through an interaction with another cat or dog, or by something lodged under the eyelid, particularly foxtails. Ulcers can also occur due to "rolling in" of the eyelids (entropion) causing the lashes to rub on the surface of the eye, extra eyelashes (ectopic cilia), or inadequate tear production (dry eye).

There are two types of internal degeneration of the cornea that can lead to corneal ulceration:

 

Question and answer

What is ulcerative keratitis?

Ulcerative keratitis is inflammation of the cornea of the eye, characterized by the presence of corneal erosions or ulcers. The cornea is the transparent part of the eye. It forms a dome that covers the iris and pupil and admits light to the interior of the eye. Inflammation can be accompanied by loss of the first layer of the cornea (corneal erosion) or loss of deeper layers (corneal ulcer). The distinction between erosion and an ulcer is sometimes difficult. Corneal ulcers can be classified as superficial or deep. Ulcerative keratitis is seen in dogs and cats. Dogs with short noses and prominent eyes are more likely to develop ulcerative keratitis. Boxers are prone to develop a severe form of ulcerative keratitis.

What causes ulcerative keratitis?

In dogs and cats, causes of ulcerative keratitis can be traumatic or nontraumatic. The causes include:

What are the signs of ulcerative keratitis?

Ulcerative keratitis may be acute (sudden and severe) or chronic (of long duration). The eye is red and painful. The eyes may water (tear) and the animal may squint and be sensitive to the light, or rub at the eyes. The eye may remain closed and discharge may be present on or around the eye and eyelids. The pet guardian may notice a "film" over the eye. If the cause is traumatic, signs of trauma (such as laceration or bleeding in eye) may be visible. Cats with herpesvirus may have a history or signs of respiratory disease.

How is ulcerative keratitis diagnosed?

Ulcerative keratitis is diagnosed through a complete eye examination (ophthalmic examination). The veterinarian will inspect the eye and cornea carefully. A test for the presence of corneal erosions or ulcers involves placing diagnostic dye onto the eye. Dye retention is diagnostic for ulcerative keratitis. Ophthalmic stains are used to help diagnose the degree and type of corneal damage. Cultures of the cornea for bacteria and fungi may be indicated in animals with progressive or deep corneal ulcers. Examination of the cells (cytology) obtained by corneal scraping may reveal microorganisms. Special blood tests (serology) can confirm feline herpesvirus, although a negative test result does not rule out herpesvirus. Ulcerative keratitis may develop concurrently with other causes of a red eye, such as conjunctivitis, uveitis (inflammation of the iris), or glaucoma. These conditions must be investigated.

How is ulcerative keratitis treated?

The treatment for ulcerative keratitis depends on the underlying cause and the severity of the corneal disease. Animals with deep or rapidly progressive ulcers may require hospitalization for surgery or frequent medical treatments. Activity is restricted. An Elizabethan collar may be placed around the animal's neck to keep the pet from pawing at the eyes. Superficial ulcers usually do not require surgery if the cause has been eliminated. Deep ulcers may be scraped (debrided) with a sterile, cotton-tipped swab to remove loose layers of the cornea. Additional surgical procedures may be beneficial and an incision may be made into the cornea for surgical repair. Full-thickness corneal lacerations should be repaired immediately.

Topically applied (placed into the eye) antibiotics, atropine, and other medications are indicated in the treatment of corneal ulcers. Antiviral agents are indicated for the treatment of cats with herpesvirus ulcers. Animals with "dry eyes" (keratoconjunctivitis sicca or KCS) will be treated with specific medications to increase tear production. Some animals may receive artificial tears. Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to decrease inflammation and to relieve pain. Contact lenses can be used as bandages to reduce irritation from the eyelids and to reduce pain. Contact lenses can be used as an alternative to or in conjunction with surgery.

What is the prognosis for animals with ulcerative keratitis?

The prognosis (outcome) for animals with ulcerative keratitis varies, depending on the underlying cause and the severity of the corneal disease. An uncomplicated, superficial ulcer should heal, usually in 5 to 7 days. A more serious ulcer may persist for weeks or even months in spite of medical therapy, but it often will heal within 2 weeks after surgery. Complications of corneal ulcers include rupture of the eye, glaucoma, and blindness. Cats with herpesvirus may need long-term antiviral medication to prevent recurrent ulcers.

The majority of the information in this page is has been taken from VetMedCenter.com. For further information about this useful source of informtion follow the link or look, on the internet, at www.vetmedcenter.com.