p.1

The top ten eye problems seen in Veterinary Practice
Robin G Stanley, Jane Whitley Matt Sanders, Heather Kaese Animal Eye Care,
Animal Eye Care, Melbourne

p.2

In this presentation
- Conjunctivitis
- Squinting
- Ocular Discharge
–Watery
–Mucky
- Dry Eye
- Corneal Ulceration
Animal Eye Care

p.3

In this presentation
- Uveitis
- Glaucoma
- Cataracts
- Prominent Eye
- Vision Loss
Animal Eye Care

p.4

Image
Animal Eye Care

p.5

Canine Conjunctivitis
- Most commonly this is bacterial conjunctivitis
- Check for a predisposing cause
– Always do a STT in all cases of conjunctivitis (and
corneal disease and ocular discharge)
– Check under the third eyelid and the eyelids
- Grass seeds
- Tumours
Animal Eye Care

p.6

Canine Conjunctivitis
- Topical Antibiotics
– Tricin – triple antibiotics, if red or inflamed Amacin
– Use TID for 5 days
– Check then recheck the STT – tear test
Animal Eye Care

p.7

Follicular Conjunctivitis
Animal Eye Care

p.8

Recurrent Canine Conjunctivitis
- Usually there is an underlying cause eg dry eye or a FB
- IF no underlying cause the recurrent cases are usually allergic
- Topical cortisone drops are indicated
– Topical cyclosporin/Tacrolimus may help

Animal Eye Care

p.9

Feline Conjunctivitis
Animal Eye Care

p.10

Feline Conjunctivitis
- Usually infectious
- Oral Doxycycline 5mg/kg BID for 21 days
- Hylo-Forte – 1 drop BID to TID
- Most cases settle down well
- If redness persists then topical NSAIDs may be needed.

Animal Eye Care

p.11

Equine Conjunctivitis
- Bacterial, viral, fungal
- Fly Control is very important
- Foreign bodies
– Check under the TE – third eyelid and also under the eyelids and the NASOLACRIMAL duct
Animal Eye Care

p.12

Image
Animal Eye Care

p.13

Unusual Equine Conjunctiva
- Fat pad prolapse
– Can cover the eye completely
– ALWAYS suture closed any conjunctival wounds or after removing the TE- third eyelid
– https://veteriankey.com/ocular-infections/
Animal Eye Care

p.14

Equine Parasitic lesions from Slideshare Dr David Ledbetter
Animal Eye Care

p.15

from Slideshare Dr David Ledbetter
Animal Eye Care

p.16

from Slideshare Dr David Ledbetter
Animal Eye Care

p.17

Canine Conjunctivitis Summary
- Dogs
– Most cases are bacterial – should respond quickly to antibiotics
– Recurrent cases
- Is it dry eye ? – Always do a STT – Schirmer Tear Test
- Allergic
Animal Eye Care

p.18

Feline Conjunctivitis Summary
- Cats
– Usually due to Herpes and or Chlamydia
– Most cases require a prolonged course of oral doxycycline 5mg/kg BID for 21 days
– Hyaluronate tears eg Hylo-Forte BID
Animal Eye Care

p.19

Squinting
- Can be caused by
– Eyelid disease eg entropion, extra eyelashes
– Corneal Ulceration
– Ocular pain
- Uveitis
- Glaucoma
– Treat the underlying cause
Animal Eye Care

p.20

Animal Eye Care

p.21

Animal Eye Care

p.22

Managing Ocular Pain
- Tramadol
- Gabapentin
Animal Eye Care

p.23

Ocular Discharge - watery
Animal Eye Care

p.24

Watery Ocular Discharge
- Do a STT – Schirmer tear test
– >20 mm wetting suggests irritation that might be
causing the epiphora
– Normal STT~ 15 mm suggests decreased nasolacrimal fluroscein passage
Animal Eye Care

p.25

Watery Ocular Discharge - epiphora
- Nasolacrimal fluroscein passage
– No passage through to the nose indicates its time to flush the tear duct
Animal Eye Care

p.26

Mucky Ocular Discharge
Animal Eye Care

p.27

Mucky Ocular Discharge
- Dry eye
- Dry eye
- Dry eye
- Chronic Conjunctivitis
- Nasolacrimal duct infection
– Dacryocystitis
• Foreign bodies
Animal Eye Care

p.28

• Do a STT – mm wetting/minute cause
- If normal think of reduced nasolacrimal drainage
-If no nasolacrimal fluorescein passage time to flush the tear duct
– If > 20 think irritation as a
– If < 15 think dry eye
Animal Eye Care

p.29

Equine Ocular Discharge
Animal Eye Care

p.30

Dry Eye – keratoconjunctivitis sicca
- Always do a STT – s¥Schirmer tear test in all cases of conjunctivitis, corneal disease and all cases of ocular disease
- Dry eye can be the cause or as the result of conjunctivitis
Animal Eye Care

p.31

Animal Eye Care

p.32

Dry Eye
- Breed predisposition
- Best results with treatment when
– Initial STT > 5mm
– Been less than 6 months
- Always do a STT
Animal Eye Care

p.33

Dry eye treatment
- Artificial Tears
– Preservative free Systane UD or Hylo-Forte
- Clean the eyes clear of all discharge before applying the active drugs
– Mucous can stop the active drugs from getting to the lacrimal glands
Animal Eye Care

p.34

Dry Eye
- Artificial Tears
– 1-2 drops to clean out all the mucous
- Optimmune – Cyclosporin Ointment
– Most cases BID
– Severe cases TID
- Cortisone ointment if the cornea is healthy enough eg Siguent Hycor
Animal Eye Care

p.35

Dry Eye Summary
- Always do a STT – early treatment gives the best results
- Optimmune BID, if STT<6 mm use TID
- Wipe away all the mucous
– Long term treatment likely
- Tacrolimus if the response is poor
Animal Eye Care

p.36

Corneal Ulceration
- Always do a STT in all cases of ulcers
- Look for a cause
- Biggest concern is infection
– Stop any topical anti-inflammatories
Animal Eye Care

p.37

Corneal Ulceration
- Look for a cause
– Dry eye – always do a STT
- Eyelids
– Entropion
– Extra Eyelashes
– Ectopic Cilia
– Oversize eyelid openings
Animal Eye Care

p.38

Corneal Ulcer Treatment
- Topical antibiotics
– Tricin – triple antibiotic
– Reserve the potent antibiotics eg Ocuflox/Gentamicin for infected corneas
- Oral Doxycycline 5mg/kg BID
Animal Eye Care

p.39

Corneal Ulcer Treatment
- Oral anti- inflammatories
– Oral NSAIDs
- Atropine
– Use only if the pupil is small
Animal Eye Care

p.40

Infected Ulcers
Animal Eye Care

p.41

Animal Eye Care

p.42

Infected Ulcers - keratomalacia
- Usually pseudomonas or Streptococcosis
- Cytology
- Antibiotics
– Use frequently
– every 5 minutes for the first hour then hourly
– Fluoroquinolone / Chloramphenicol OR
– Fortified Gentamicin
Animal Eye Care

p.43

Infected Ulcers - keratomalacia
- Oral Doxycycline 5mg/kg
- Atropine BID
- Oral NSAIDs
- Serum drops
Animal Eye Care

p.44

Consider Surgery
- TT – temporary tarsorrhaphy
- Contact lens
- TEF – third eyelid flap
- Conjunctival grafting
Animal Eye Care

p.45

Corneal Ulcer Summary
- Always looks for an underlying cause
- Always do a STT
- Antibiotics – topical and oral doxycycline
- Oral NSAIDs
Animal Eye Care