Corneal Ulcers with Dr Denis Goulding

Story from the March 2019 Horse Deals magazine.

Corneal ulcers are one of the most common injuries that can occur with horses and should be treated as a matter of urgency to ensure the eye sight is not compromised.

An extremely painful condition, ulcers vary in size and depth and can quickly escalate to corneal perforation. Corneal injuries are prone to secondary infections that can result in an abscess or a non-healing ulcer that requires surgical intervention.

Symptoms
Ulcers will usually present with excessive tearing and blinking, inflammation of the conjunctiva (lining of the eye often red in colour), heat and may present with clouding at the ulcer site.

Diagnosis
Veterinary examination is required to confirm the diagnosis and treatment. The veterinarian will assess the severity of the ulcer. Diagnosis is performed by staining the eye with a fluorescein dye usually bright green in colour. The dye will adhere to the cornea where the lesion is present. With a deep or non-healing ulcer, swabs or biopsies are frequently required to determine the presence and type of bacteria and fungi.

Treatment
The administration of pain relief is required, along with a treatment plan based on the type of ulcer, and may include medications such as topical antibiotics, antifungals, anti-proteinases and atropine. The frequency of treatment will also vary dependent upon the type of ulcer, and may vary from hourly administration of ointment to twice daily as directed by the veterinarian.

Whilst most ulcers will resolve within a few days there is a percentage of corneal ulcers that are difficult to treat, known as indolent ulcers. Surgical intervention involving debriding the ulcer surface and a corneal graft may be required for a successful outcome.

If your horse is exhibiting any signs of a corneal ulcer it is recommended that you remove the horse from direct sunlight wherever possible. Cover the affected eye with an eye patch (racing blinkers with an eye patch is ideal, or even a fly mask) to block out light until your veterinarian arrives.

Do not be complacent if you suspect a corneal ulcer. Contact your veterinarian for attention, diagnosis and treatment.

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