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Overview and Risks
Has your feline friend had irritated eyes lately? It could be a corneal ulcer. Injuries to the cornea have many causes:
All cats are at risk for a corneal ulceration, but breeds with flat faces or pronounced eyes like the Himalayan, Persian, or Burmese are at greater risk. Chronic ulcers of the eye occur more frequently in senior cats.
Ulcers of the eye are very painful and your cat may paw at his or her eye. Additional signs may be:
Diagnosis and Treatment
Besides causing your cat a lot of pain and misery, an untreated corneal ulcer can cause blindness. Your veterinarian will want to examine your kitty’s eye(s) very carefully to determine if there is an ulcer of the eye. The exam may include the following:
If your veterinarian determines your kitty has an ulcer of the eye they may recommend the following treatment:
It is critical that you administer all the medication your veterinarian prescribes for your feline friend.
Because there are so many different causes of an ulcer of the eye, there is no single preventive method that works for every situation. To help reduce your furry friend’s risk of eye problems, check his or her eyes daily for any obvious signs of irritation such as redness or tearing. Most importantly contact your veterinarian if you suspect your cat’s eyes look irritated or inflamed.
Can I treat my cat’s eye infection at home?
Whether with natural antibiotics or over the counter options, should never try to treat your cat eye infection at home. There are various diseases that can produce similar symptoms. Without a proper diagnosis, you may not know exactly what your furry friend is suffering from.
Is the cat’s eye infection contagious?
Both bacterial and viral pink eye infections are highly contagious in cats. These can be transmitted from one cat to another through direct contact.
Do cats blink one eye at a time?
Felines have a third eyelid, also called the nictating membrane. It closes from the side and helps lubricate the eye and reduce the frequency of blinking. If one eye becomes dry, your cat may casually blink only one eye in order to moisturize it.
Sara has a corneal ulcer, which is known to be extremely painful.
Well, more specifically, this is Sara’s right eye.
Sara’s first visit with this eye problem was about a week ago, and she presented with a history of squinting and protecting the eye.
We examined Sara thoroughly, and found no other physical problems on the body, so we turned our focus to the eye. Instillation of fluorescein stain showed a large area of the cornea was damaged. The shape of the lesion was consistent with a scrape that may have come from “sister” Lil’ Catherine, from running into a stick, or any number of other possible causes of corneal trauma.
We began symptomatic therapy, treating with an antibiotic to ensure the ulcer didn’t become infected, and with oral and topical pain medication. Corneal ulcer is known, from experience of people, to be the second most painful injury we can experience, second only to passing a kidney stone.
At our first evaluation a week later we discovered that there was little healing, although it seemed that Sara didn’t squint as much as the previous week.
At that time we added a treatment called autogenous serum, also called autologous serum. This form of treatment is relatively easy to make right in our own hospital’s lab. We draw blood, abour four times as much as one might need for a chemistry profile. The blood is allowed to clot, then it is centrifuged to separate the blood cells from the blood liquid, called serum. The serum is collected into a vial that can be used to dispense drops into the eye 3-4 times daily. Often the healing effect made from one’s own body can be dramatic.
After an additional week of treatment Sara’s cornea looks better, but still hasn’t healed completely. In fact, it seems to have reached a certain point of healing, then stopped. This is typical behavior for an indolent ulcer, one that tries to heal, but simply cannot reach complete healing.
The best and most modern next step for lesions such as Sara’s is to create a crosshatch on the cornea. To accomplish that, the patient goes under general anesthesia, the eyelids are propped open with a speculum to allow easy and full access to the cornea, and a small, sharp instrument is used to make tiny, shallow incisions across the entire cornea, incorporating the lesion. The process is believed to simply “tell” the body that there is something going on in the eye that needs immediate healing attention, for it to get off its duff and get back to healing, just as it should any incision or laceration.
Today, however, we used an older technique that has proven itself very successful over a number of decades. It doesn’t require general anesthesia, just topical anesthesia on the eye itself, and a little sedation. Some dogs will even tolerate this procedure without sedation.
With some ophthalmic anesthetic on the cornea, and some applied to a sterile surgical sponge, the lesion and a little area around it are “scrubbed” gently. The effect is very similar to the crosshatching treatment above, in that defensive and healing mechanisms are activated, and the sluggish healing is then speeded up.
Sara had a very successful procedure today, as we saw a substantial amount of unattached corneal tissue appear on our surgical sponge.
We will evaluate Sara’s healing again in three days, and anticipate a rapid recovery.
By Dr. Amanda Corr, VMD, DACVO| Ophthalmology
Corneal ulcers occur in pets when they experience trauma on the surface layer of their eyes. This trauma can occur through abrasions, scratches, infection, and more, resulting in deeper layers of the cornea being lost. Here Dr. Amanda Corr, Ophthalmology, VMD, DACVO answers some of the most important questions about corneal ulcers in pets.
What is the cornea?
Dr. Amanda Corr: The clear, outer surface of the eye is called the cornea. It is often referred to as the ‘windshield’ of the eye and a healthy cornea is essential for normal vision. It is made up of many layers of cells which are arranged very specifically so that the cornea is crystal clear. The outer layers of the cornea are called the epithelium and are intimately attached to the deeper layers called the stroma. One of the most sensitive parts of the body, the cornea has many nerve endings for pain perception. However, it does not contain any blood vessels. Instead, the cornea receives oxygen and nutrition from the tears which are spread over the cornea when the animal blinks.
What is a corneal ulcer?
Corneal ulcers may also be called ‘scratches’ or ‘abrasions’ and are a very common eye problem diagnosed in pets. Ulcers are essentially open wounds within the cornea. If an animal’s cornea becomes ulcerated it can be very painful. Most ulcers heal within a week however, certain types of ulcers may require specialized procedures to heal. If an ulcer becomes infected it can rapidly develop into a deep wound or perforation. What causes corneal ulcers in pets? There are many different reasons that an animal may have a corneal ulcer. Most commonly, an animal develops an ulcer due to trauma — they may be scratched while exploring outside, playing with another animal or aggressively rubbing their eye. A pet is at higher risk for corneal ulceration if they have an underlying condition such as a tear deficiency or an abnormally placed eyelash that may be rubbing on the cornea. Brachycephalic, or “short-headed,” animals such as the pug dog or Persian cat, are at higher risk for corneal ulcers due to increased exposure of the eye and poor blink coverage over the cornea.
What signs can you look for to determine if your pet may have a corneal ulcer and needs to be examined by the veterinarian?
The most common symptoms of a corneal ulcer are squinting, redness, and ocular discharge. Ulcers are typically painful, and the animal will squint, blink excessively, or even hold its eye completely closed. The normally white part of the eye (sclera) often becomes very red and may even be swollen. The front of the eye may become hazy or cloudy. Animals with corneal ulcers often have excessive tearing. If the ulcer is due to a tear deficiency, the discharge can even be thick like mucous ranging from clear to white, yellow, or green. Other symptoms that may be a sign of a corneal ulcer include: rubbing of the eye, a cloudy eye, and lethargy or decreased appetite if the animal is painful.
Any of these signs should prompt the owner to take their pet to the veterinarian and the pet should be checked for an ulcer. A simple test called a fluorescein stain test is used to diagnose a corneal ulcer. Fluorescein is a special stain dropped into the eye that attaches to an ulcer and can be seen with a specialized blue light.
How are corneal ulcers treated?
Corneal ulcers can be classified into ‘simple’ and ‘complicated.’ Most ulcers are simple, involve only the outer layers of corneal cells called the epithelium and heal within three to seven days. The body heals itself by sliding new healthy layers of epithelium over the wound and these layers attach to the deeper layers (stroma). Antibiotic drops or ointments are used to prevent an infection. Pain medications are often provided in the form of either a pill and/or a topical medication called Atropine. Depending on the underlying cause of the corneal ulcer, additional medications may be warranted. If the ulcer is complicated by infection, additional medications are also used at a greater frequency. An E-collar is always essential to prevent the pet from rubbing and allow the cornea to heal properly.
When do I know to stop giving my pet medicine for corneal ulceration?
The only way to know that the corneal ulcer has healed is by visiting the veterinarian who will repeat the fluorescein stain test. Once the veterinarian has confirmed healing, the medication is typically discontinued, and the E-collar can be removed.
What is an indolent corneal ulcer?
Indolent corneal ulcers are ulcers which do not heal in a normal way and within the normal time frame. In dogs, this type of ulcer may also be called a Boxer ulcer or spontaneous chronic corneal epithelial defect (SCCED). Indolent ulcers in dogs often occur due to an underlying defect in the cornea that prevents the outer epithelial cells from attaching to the deeper stromal cells. In cats, indolent ulcers are often due to a viral infection.
In order to allow healing of an indolent ulcer, a minimally invasive procedure may need to be performed by the veterinary ophthalmologist. This procedure is done using topical anesthesia. The first step involves debridement of the unattached epithelial cells using a dry sterile cotton swab. This clears the cornea of excessive, dead epithelial cells that are interrupting the healing process. Next, either a special instrument called a diamond burr or very small needle tip will be used to place small grooves within the stroma (keratotomy). This creates a roughened surface for new epithelial cells to attach on to and heal over. This second step, the keratotomy, should not be done in cats. Lastly, a soft bandage contact lens may be placed on the cornea to help facilitate healing. The contact lens will also provide comfort during the healing process. These procedures have an 85-95 percent success rate. Very rarely, an indolent ulcer requires a surgical procedure called a keratectomy which is done under general anesthesia.
A corneal ulcer is an open sore of the cornea, which is the transparent dome-shaped layer that covers the front of the eye.
The cornea protects the eye from dust, germs, and other debris, as well as reshaping and focusing light rays onto the retina it consists of five layers.
Tears bathe the cornea to keep it nourished and prevent it from drying out.